NPIMap

Organization Active NPI

Eastern Plumas Health Care District

Doing business as Eastern Plumas Health Care

  • Skilled Nursing Facility
  • Portola, CA
National Provider Identifier
1609872415
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
555433 Issued in CA
Legal business name
EASTERN PLUMAS HEALTH CARE DISTRICT
Doing business as
Eastern Plumas Health Care
Practice address
500 1St Ave
Portola, CA 96122-9406
Phone
(530) 832-6500
Fax
(530) 832-1105
NPI assigned
Jun 27, 2005
Last updated
Nov 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Ms. Jerilee Nelson, CPA
Title
Cfo
Phone
(530) 832-6578

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 230000014 CA
Skilled Nursing Facility 314000000X 555433 CA Primary

Addresses

Primary practice location

500 1St Ave
Portola, CA 96122-9406

Mailing address

500 1St Ave
Portola, CA 96122-9406
Phone (530) 832-6500

Other identifiers 2

IdentifierTypeStateIssuer
LTC55433FMedicaidCA
050566OtherBC

Other names 1

  • EASTERN PLUMAS HEALTH CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100211000104 CA Part A Provider - Skilled Nursing Facility 4587576889 Practice locations: Portola, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609872415. Details of each certification follow.

Skilled nursing facility certification: CCN 555433

Legal name
EASTERN PLUMAS HEALTH CARE DISTRICT
Doing business as
EASTERN PLUMAS HEALTH CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Sep 11, 1990
Last certification
Aug 15, 2024
Beds
66
Ownership / control type
Hospital District
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1981 in CA
Enrollment address
500 1St Ave
Portola, CA 96122-9406
Nursing home name
EASTERN PLUMAS HOSPITAL- PORTOLA CAMPUS DP/SNF

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Eastern Plumas Hospital- Portola Campus DP/SNFCCN 555433 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Sep 11, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6659.8 residents per day on average
Penalties (3 years)
3Fines totaling $69,450

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Eastern Plumas Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gail McGrath Individual Corporate DirectorDirector Apr 1, 2007
Harvey West Individual Corporate DirectorDirector Aug 1, 2016
Eastern Plumas Health Care District Organization Other Sep 11, 1990
Teresa Whitfield Individual Corporate DirectorDirector Jan 1, 2019
William Copren Individual Corporate DirectorDirector Jan 1, 2019
Paul S Swanson Individual Corporate DirectorVice Chair Jan 1, 2014
Katherine a Pairish Individual W-2 Managing EmployeeChief Financial Officer Jul 1, 2018
Nicole Johnson Individual Corporate DirectorDirector Jan 1, 2019
Jay Skutt Individual Corporate DirectorChairman Jan 1, 2010

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eastern Plumas Health CarePortola, CA, CCN 051300 Hospital Operational/Managerial Control Oct 24, 2000
Eastern Plumas Health Care DistrictGraeagle, CA, CCN 553985 Rural health clinic Other Jan 1, 2013
Portola Medical ClinicPortola, CA, CCN 058522 Rural health clinic Other Jan 1, 2013

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1609872415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 1ST AVE",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961229406",
            "telephone_number": "530-832-6500",
            "fax_number": "530-832-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 1ST AVE",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961229406",
            "telephone_number": "530-832-6500",
            "fax_number": "530-832-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PLUMAS HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JERILEE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-832-6578",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000014",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "555433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55433F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "050566",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTERN PLUMAS HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portola, CA

Sources for this page

Verify at the official NPI Registry.