Active NPI
Sonora Community Hospital
- Community Based Hospice Care Agency
- Sonora, CA
National Provider Identifier
1437389657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 100000558
- Legal business name
- SONORA COMMUNITY HOSPITAL
- Practice address
- 20100 Cedar Rd N
Sonora, CA 95370-5925 - Phone
- (209) 536-5700
- Fax
- (209) 532-3238
- NPI assigned
- Jul 22, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David L. Larsen
- Title
- Vice President for Finance
- Phone
- (209) 536-5011
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 100000558 | CA | Primary |
Addresses
Primary practice location
20100 Cedar Rd N
Sonora, CA 95370-5925
Mailing address
14542 Lolly LN
Sonora, CA 95370-9226
Phone (209) 536-2925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10000558 | Other | CA | LICENSE |
Other names 1
- Hospice Of The Sierra
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider DirectoryOwnership & related parties
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Aug 1, 2019 | Change of Ownership | Adventist Health Home Care Services |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Community Based Hospice Care Agency
- Sonora, CA
- NPI 1104456391
Sold to, 2019-08-01
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1248220800000",
"number": "1437389657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14542 LOLLY LN",
"city": "SONORA",
"state": "CA",
"postal_code": "953709226",
"telephone_number": "209-536-2925",
"fax_number": "209-533-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20100 CEDAR RD N",
"city": "SONORA",
"state": "CA",
"postal_code": "953705925",
"telephone_number": "209-536-5700",
"fax_number": "209-532-3238"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SONORA COMMUNITY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-22",
"last_updated": "2009-07-22",
"status": "A",
"authorized_official_last_name": "LARSEN",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE",
"authorized_official_telephone_number": "209-536-5011",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CA",
"license": "100000558",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "10000558",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hospice Of The Sierra",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.