NPIMap

Organization Active NPI

Reedley Community Hospital

  • Rural Health Clinic/Center
  • Dinuba, CA
National Provider Identifier
1427025691
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
040000140 Issued in CA
Legal business name
REEDLEY COMMUNITY HOSPITAL
Practice address
1451 E El Monte Way
Dinuba, CA 93618-1812
Phone
(559) 587-4349
Fax
(559) 587-4366
NPI assigned
Mar 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Andrea Kofl
Title
Central Valley Network President
Phone
(559) 537-0056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 040000140 CA Primary

Addresses

Primary practice location

1451 E El Monte Way
Dinuba, CA 93618-1812

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (559) 587-4349

Other identifiers 1

IdentifierTypeStateIssuer
RHM08613FMedicaidCA

Other names 1

  • Adventist Health Reedley - Dinuba Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151106002136 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Dinuba, CA

Rural health clinic certification: CCN 058613

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 13, 2005
Last certification
Aug 5, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2011 in CA
Enrollment address
1451 E El Monte Way
Dinuba, CA 93618-1812
Related CCNs
050196

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
05D1052059Adventist Health Reedley1451 E El Monte Way, Dinuba, CA 93618Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 14, 2015
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Andrea S Kofl Individual Corporate OfficerPresident Feb 27, 2017
W-2 Managing EmployeePresident/Ceo Feb 27, 2017
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Todd N Hofheins Individual Corporate OfficerVice Chair Jan 24, 2022
Lucy a Ocampo Individual Corporate DirectorBoard Member Jul 1, 2019
David P Banks Individual Corporate DirectorBoard Member May 5, 2017
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Timothy M Haydock Individual Corporate OfficerTreasurer/Assistant Secretary Jul 3, 2017
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Corporation Operational/Managerial Control Jan 1, 2012 100%

Facilities with the same owner 105

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1427025691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888806",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888806",
            "telephone_number": "559-587-4349",
            "fax_number": "559-587-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181812",
            "telephone_number": "559-587-4349",
            "fax_number": "559-587-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEDLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "KOFL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CENTRAL VALLEY NETWORK PRESIDENT",
        "authorized_official_telephone_number": "559-537-0056"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "040000140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08613F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Reedley - Dinuba",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dinuba, CA

Sources for this page

Verify at the official NPI Registry.