NPIMap

Organization Active NPI

Southern Monterey County Memorial Hospital

Doing business as G. L. Mee Memorial Hospital Specialty Clinic

  • Clinic/Center
  • King City, CA
National Provider Identifier
1386955433
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
070000047 Issued in CA
Legal business name
SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Doing business as
G. L. Mee Memorial Hospital Specialty Clinic
Practice address
400 Canal St
Ste B
King City, CA 93930-3461
Phone
(831) 386-7401
Fax
(831) 386-7402
NPI assigned
Jun 23, 2010
Last updated
Dec 17, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susan Childers
Title
Cfo
Phone
(831) 385-7160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 070000047 CA Primary

Addresses

Primary practice location

400 Canal St
Ste B
King City, CA 93930-3461

Mailing address

400 Canal St
Ste B
King City, CA 93930-3461
Phone (831) 386-7401

Other names 1

  • G. L. Mee Memorial Hospital Specialty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110329000913 CA Part B Supplier - Clinic/Group Practice 7719883461 Receives reassigned benefits from 3 practitioners
Practice locations: King City, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2241136Specialty Clinic400 Canal St Suite B, King City, CA 93930Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Southern Monterey County Memorial Hospital26 organizations share this tax ID, including this one
Part of
Southern Monterey County Memorial Hospital

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

400 Canal St
Ste C
King City, CA 93930
Phone (831) 385-7200

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mee Memorial Children's Health and Wellness CenterKing City, CA, CCN 058732 Rural health clinic Operational/Managerial Control Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1386955433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CANAL ST",
            "address_2": "STE B",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303461",
            "telephone_number": "831-386-7401",
            "fax_number": "831-386-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CANAL ST",
            "address_2": "STE B",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303461",
            "telephone_number": "831-386-7401",
            "fax_number": "831-386-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2010-06-23",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "831-385-7160",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "070000047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "G. L. Mee Memorial Hospital Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in King City, CA

Sources for this page

Verify at the official NPI Registry.