Organization Active NPI

Atherton Baptist Homes

  • Skilled Nursing Facility
  • Alhambra, CA
National Provider Identifier
1528049954
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
ZZZT18524FMedicaidCA

Other names 1

  • Sam B West Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 HomeCCN 555272
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11360.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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
05D0565394Atherton Baptist Homes214 S Atlantic Blvd, Alhambra, CA 91801Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Joelle Elaine Medina Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Mar 14, 2025
Tarek R Nassif Individual Operational/Managerial Control Jan 1, 2016
Adp of the SNF Mar 14, 2025
Atherton Baptist Homes Organization, Alhambra, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 1987 100%
Adp of the SNF Mar 1, 1926
Brett Meredith Individual Corporate OfficerCeo Oct 1, 2024 100%
Ma Jocelyn Pascual Individual Corporate OfficerCfo 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.

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

Verify at the official NPI Registry.