Vista Hospital of South Bay, LP

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

VISTA HOSPITAL OF SOUTH BAY, LP

Practice address

1246 W 155TH St
Gardena, CA 90247-4011

Phone

(310) 323-5330

Fax

(310) 768-2265

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Marc C Ferrell

Title

Senior VP

Phone

(562) 715-0974

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 050456

Legal name

VISTA HOSPITAL OF SOUTH BAY

Certification status

Terminated Voluntary: merger or closure, Sep 30, 2006

Provider type (POS)

Hospital – Short-term

Participating since

Dec 31, 1971

Last certification

Jun 22, 1993

Beds

58

Ownership / control type

Private (for profit)

Most recent change of ownership

Jan 1, 2006 (5 total)

Facility address

1246 W 155TH St
Gardena, CA 90247

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond N Smith, FNP

  • Family Nurse Practitioner
  • Pomona, CA
  • NPI 1609941632
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1619061660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 W 155TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474011",
            "telephone_number": "310-323-5330",
            "fax_number": "310-768-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 W 155TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474011",
            "telephone_number": "310-323-5330",
            "fax_number": "310-768-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA HOSPITAL OF SOUTH BAY, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "562-715-0974"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40456I",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30456I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darlene Viramontes
• Mayra Alexandra Virgen
• Harmeet Kaur Virk, B.A.
• Kaitlyn Visser
• Vista del Mar Child and Family Services
• Nancy Jazmin Vital
• Marlene Vivar
• Tanya Vivas, MSW
• Jesus C Viveros
• Patricia Voltaire

• Long Term Care Hospital in Gardena, CA
• Providers in Gardena, CA by specialty
• Long Term Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.