NPIMap

Organization Active NPI

Sutter Central Valley Hospitals

Doing business as Memorial Medical Center

  • General Acute Care Hospital
  • Modesto, CA
National Provider Identifier
1629059746
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
030000061 Issued in CA
Legal business name
SUTTER CENTRAL VALLEY HOSPITALS
Doing business as
Memorial Medical Center
Practice address
1700 Coffee Rd
Modesto, CA 95355-2803
Phone
(209) 526-4500
NPI assigned
Nov 7, 2005
Last updated
Apr 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
John Gates
Title
Cfo Shba
Phone
(510) 450-7357

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 030000061 CA Primary
Clinical Medical Laboratory 291U00000X 05D0609849 CA

Addresses

Primary practice location

1700 Coffee Rd
Modesto, CA 95355-2803

Mailing address

PO Box 740152
Los Angeles, CA 90074-0152
Phone (855) 398-1633

Other identifiers 5

IdentifierTypeStateIssuer
HSP40557FMedicaidCA
ZZR00603FMedicaidCA
HSC00557FMedicaidCA
MTA00603FMedicaidCA
ZZR00154FMedicaidCA

Other names 1

  • Memorial Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sutter Community Hospit27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1629059746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740152",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740152",
            "telephone_number": "855-398-1633",
            "fax_number": "209-572-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER CENTRAL VALLEY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO SHBA",
        "authorized_official_telephone_number": "510-450-7357"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "030000061",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0609849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40557F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR00603F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC00557F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTA00603F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR00154F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.