NPIMap

Organization Active NPI

Kaweah Delta Health Care District

Doing business as Kaweah Health Medical Clinic - Willow Specialty

  • Multi-Specialty Clinic/Center
  • Visalia, CA
National Provider Identifier
1578081915
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
KAWEAH DELTA HEALTH CARE DISTRICT
Doing business as
Kaweah Health Medical Clinic - Willow Specialty
Practice address
202 W Willow Ave Ste 202
Visalia, CA 93291-6238
Phone
(559) 624-2739
NPI assigned
Sep 6, 2017
Last updated
Jan 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KAWEAH DELTA HEALTH CARE DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Malinda Tupper
Title
Sr. VP/Cfo
Phone
(559) 624-4065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

202 W Willow Ave Ste 202
Visalia, CA 93291-6238

Mailing address

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2739

Other names 1

  • Kaweah Health Medical Clinic - Willow Specialty Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address providerenrollment@kdhcd.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110914000795 CA Part B Supplier - Clinic/Group Practice 6608778790 Receives reassigned benefits from 204 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Visalia, CA; Los Angeles, CA; Bakersfield, CA; Hanford, CA; Irvine, CA; Long Beach, CA; Tulare, CA; Santa Barbara, CA

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Kaweah Delta Non Inv Ca27 organizations share this tax ID, including this one
Part of
Kaweah Delta Non Inv Ca

Other organizations with this tax ID 26

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

View all 26

Locations

1329 N Plaza Dr
Visalia, CA 93291
Phone (559) 624-6250

202 W Willow Ave
Ste 107
Visalia, CA 93291
Phone (559) 624-6570

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1578081915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916237",
            "telephone_number": "559-624-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W WILLOW AVE STE 202",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916238",
            "telephone_number": "559-624-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "enumeration_date": "2017-09-06",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "TUPPER",
        "authorized_official_first_name": "MALINDA",
        "authorized_official_title_or_position": "SR. VP/CFO",
        "authorized_official_telephone_number": "559-624-4065"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "providerenrollment@kdhcd.org",
            "affiliation": "N",
            "address_1": "202 W Willow Ave Ste 202",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932916238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaweah Health Medical Clinic - Willow Specialty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.