NPIMap

Organization Active NPI

Community Health Systems, Inc.

Doing business as Bloomington Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bloomington, CA
National Provider Identifier
1487706347
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
240000086 Issued in CA
Legal business name
COMMUNITY HEALTH SYSTEMS, INC.
Doing business as
Bloomington Community Health Center
Practice address
18601 Valley Blvd
Bloomington, CA 92316-1831
Phone
(909) 546-7520
Fax
(909) 877-5468
NPI assigned
Jan 18, 2007
Last updated
Apr 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Lori Nanette Holeman
Title
Ceo
Phone
(951) 571-2300

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 40093 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 46894 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 40996 CA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 47987 CA
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPT12626TPA CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 387455 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A98737 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A110976 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A87726 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 506572 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A1157855 CA
Federally Qualified Health Center (FQHC) 261QF0400X 240000086 CA Primary

Addresses

Primary practice location

18601 Valley Blvd
Bloomington, CA 92316-1831

Mailing address

7880 Mission Grove Pkwy S
Riverside, CA 92508-6000
Phone (951) 571-2300

Other names 1

  • Bloomington Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051117000822 CA Part B Supplier - Clinic/Group Practice 7012824717 Receives reassigned benefits from 84 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, CA; Fallbrook, CA; Moreno Valley, CA; Riverside, CA
O20070305000807 CA Part A Provider - Federally Qualified Health Center (FQHC) 7012824717 Practice locations: Bloomington, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487706347. Details of each certification follow.

Federally qualified health center certification: CCN 051896

Legal name
COMMUNITY HEALTH SYSTEMS INC
Doing business as
BLOOMINGTON COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 13, 1993
Last certification
Sep 13, 1993
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 17, 1984 in CA
Enrollment address
18601 Valley Blvd
Bloomington, CA 92316-1831

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Rodger Lehl Individual Corporate Director Oct 5, 2009
Draymond Crawford Individual Corporate Director Oct 5, 2009
W-2 Managing Employee Oct 5, 2009
Vanessa I Ortiz Individual W-2 Managing EmployeeExecutive Assistant Oct 5, 1985
Yolanda Gomez Individual W-2 Managing Employee Oct 5, 2009
Oscar Ulric Jones Individual Corporate Director Oct 5, 2009
Deneen Culberson Individual Corporate DirectorBoard Member Nov 25, 2020
Jonnathan Barajas Individual Corporate DirectorBoard Member Nov 25, 2020
Lori Holeman Individual Corporate OfficerCeo Jan 1, 2017
Corporate Director Oct 5, 2009

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Magnolia Community Health CenterRiverside, CA, CCN 751009 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2012
University Community Heath CenterRiverside, CA, CCN 751025 Federally qualified health center Operational/Managerial Control (100%) Oct 9, 2025
Bloomington Community Health Center- Building 2Bloomington, CA, CCN 921140 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 14, 2024
Jun 14, 2024

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1487706347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7880 MISSION GROVE PKWY S",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925086000",
            "telephone_number": "951-571-2300",
            "fax_number": "951-200-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 VALLEY BLVD",
            "city": "BLOOMINGTON",
            "state": "CA",
            "postal_code": "923161831",
            "telephone_number": "909-546-7520",
            "fax_number": "909-877-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "HOLEMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "NANETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-571-2300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40093",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46894",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40996",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "47987",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12626TPA",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "387455",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A98737",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A110976",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87726",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "506572",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A1157855",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "240000086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomington Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, CA

Sources for this page

Verify at the official NPI Registry.