NPIMap

Organization Active NPI

Veterans Home of California

  • Military Hospital
  • Yountville, CA
National Provider Identifier
1568616480
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military HospitalTaxonomy code 286500000X
License
15000494 Issued in CA
Legal business name
VETERANS HOME OF CALIFORNIA
Practice address
100 California Dr
Medical Staff Office
Yountville, CA 94599-1411
Phone
(707) 944-4716
Fax
(707) 944-5052
NPI assigned
Nov 5, 2008
Last updated
Nov 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Marcella M. McCormack, R.D., MPS
Title
Administrator
Phone
(707) 944-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Hospital 286500000X 15000494 CA Primary

Addresses

Primary practice location

100 California Dr
Medical Staff Office
Yountville, CA 94599-1411

Mailing address

PO Box 942895
Sacramento, CA 94295-0001
Phone (916) 653-0080

Other identifiers 1

IdentifierTypeStateIssuer
DA1272OtherCARAILROAD MEDICARE

Other names 1

  • N.M. Holderman Memorial Hospital Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031226000251 CA Part B Supplier - Clinic/Group Practice 5799683827 Receives reassigned benefits from 26 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yountville, CA

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1568616480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 942895",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942950001",
            "telephone_number": "916-653-0080",
            "fax_number": "916-653-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CALIFORNIA DR",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "YOUNTVILLE",
            "state": "CA",
            "postal_code": "945991411",
            "telephone_number": "707-944-4716",
            "fax_number": "707-944-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETERANS HOME OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-944-4501",
        "authorized_official_credential": "R.D., MPS"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "CA",
            "license": "15000494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1272",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N.M. Holderman Memorial Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yountville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.