NPIMap

Organization Active NPI

Reedley Community Hospital

  • Rural Health Clinic/Center
  • Dinuba, CA
National Provider Identifier
1508881376
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
040000149 Issued in CA
Legal business name
REEDLEY COMMUNITY HOSPITAL
Doing business as
Adventist Health Community Care-Dinuba West
Adventist Health Reedley - Dinuba West
Practice address
250 W El Monte Way
Dinuba, CA 93618-1554
Phone
(559) 595-9890
Fax
(559) 595-9398
NPI assigned
Jul 13, 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 040000149 CA Primary

Addresses

Primary practice location

250 W El Monte Way
Dinuba, CA 93618-1554

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (559) 595-9890

Other identifiers 1

IdentifierTypeStateIssuer
RHM53821GMedicaidCA

Other names 2

  • Adventist Health Community Care-Dinuba West Doing business as
  • Adventist Health Reedley - Dinuba West Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120328000856 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Dinuba, CA

Rural health clinic certification: CCN 058568

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 2, 1994
Last certification
May 3, 2016
Ownership / control type
2B
Most recent change of ownership
Nov 1, 2011 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2011 in CA
Enrollment address
250 W El Monte Way
Dinuba, CA 93618-1554
Related CCNs
050192

Facilities connected through Provider of Services related, parent or unit certification numbers.

National Provider Directory

National Provider Directory
Tax ID family
Reedley Community Hospital37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All disclosed owners & managing parties 17

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 15, 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 Director 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 DirectorVice 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
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 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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1508881376",
    "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": "559-595-9890",
            "fax_number": "559-595-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181554",
            "telephone_number": "559-595-9890",
            "fax_number": "559-595-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEDLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "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": "040000149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53821G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Community Care-Dinuba West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Community Care-Dinuba West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Reedley - Dinuba West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dinuba, CA

Sources for this page

Verify at the official NPI Registry.