Active NPI
Atherton Baptist Homes
- Skilled Nursing Facility
- Alhambra, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ATHERTON BAPTIST HOMES
- Practice address
- 214 S Atlantic Blvd
Alhambra, CA 91801-3298 - Phone
- (626) 289-4178
- Fax
- (626) 576-0857
- NPI assigned
- Nov 11, 2005
- 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. Donald Lloyd Smith, NHA 3423
- Title
- Administrator
- Phone
- (626) 289-4178
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | CA | Primary |
Addresses
Primary practice location
214 S Atlantic Blvd
Alhambra, CA 91801-3298
Mailing address
214 S Atlantic Blvd
Alhambra, CA 91801-3298
Phone (626) 289-4178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZT18524F | Medicaid | CA |
Other names 1
- Sam B West Health Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100619000172 | CA | Part A Provider - Skilled Nursing Facility | 5597895441 | Practice locations: Alhambra, CA |
Skilled nursing facility certification: CCN 555272
- Legal name
- ATHERTON BAPTIST HOMES
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 1, 1987
- Last certification
- Nov 7, 2024
- Beds
- 113
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Mar 26, 1914 in CA
- Enrollment address
- 214 S Atlantic Blvd
Alhambra, CA 91801-3257 - Nursing home name
- ATHERTON BAPTIST HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Atherton Baptist Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 1, 1987
- Medicare certification status
- Active
- Certified beds
- 113
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0565394 | Atherton Baptist Homes | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Joelle Elaine Medina | Operational/Managerial Control | Nov 1, 2021 | |
| Adp of the SNF | Mar 14, 2025 | ||
| Tarek R Nassif | Operational/Managerial Control | Jan 1, 2016 | |
| Adp of the SNF | Mar 14, 2025 | ||
| Atherton Baptist Homes | 5% Or Greater Direct Ownership Interest | Mar 1, 1987 | 100% |
| Adp of the SNF | Mar 1, 1926 | ||
| Brett Meredith | Corporate Officer | Oct 1, 2024 | 100% |
| Ma Jocelyn Pascual | Corporate Officer | May 1, 2002 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- San Gabriel, CA
- NPI 1730124611
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1528049954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 S ATLANTIC BLVD",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918013298",
"telephone_number": "626-289-4178",
"fax_number": "626-576-0857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 S ATLANTIC BLVD",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918013298",
"telephone_number": "626-289-4178",
"fax_number": "626-576-0857"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHERTON BAPTIST HOMES",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "LLOYD",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "626-289-4178",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "NHA 3423"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZT18524F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam B West Health Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.