NPIMap

Organization Active NPI

Adventist Health Delano

Doing business as Wasco Medical Plaza

  • General Acute Care Hospital
  • Wasco, CA
National Provider Identifier
1639207343
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
120000180 Issued in CA
Legal business name
ADVENTIST HEALTH DELANO
Doing business as
Wasco Medical Plaza
Practice address
2300 7TH St
Wasco, CA 93280-1585
Phone
(661) 758-4187
NPI assigned
Mar 2, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Meredith Jobe
Title
Secretary
Phone
(916) 406-1576

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
General Acute Care Hospital 282N00000X 120000180 CA Primary

Addresses

Primary practice location

2300 7TH St
Wasco, CA 93280-1585

Mailing address

1401 Garces Hwy
Delano, CA 93215-3690
Phone (661) 725-4800

Other identifiers 2

IdentifierTypeStateIssuer
HAP08539FMedicaidCA
RHM08539FMedicaidCA

Other names 1

  • Wasco Medical Plaza Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20020918000013 CA Part A Provider - Rural Health Clinic 1254248016 Practice locations: Delano, CA; Wasco, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639207343. Details of each certification follow.

Rural health clinic certification: CCN 058539

Legal name
ADVENTIST HEALTH DELANO
Doing business as
ADVENTIST HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 27, 1996
Last certification
Jun 28, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 10, 1990 in CA
Enrollment address
2300 7TH St
Wasco, CA 93280-1585
Related CCNs
050608

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0913346Wasco Medical Plaza2300 7TH Street, Wasco, CA 93280Certificate of waiverMar 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Central California Foun8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2300 7th St
Wasco, CA 93280
Phone (661) 454-3729

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Adventist Health Delano Organization, Delano, CA Chain home office Operational/Managerial Control Dec 31, 2019 100%
Jason Wells Individual Corporate OfficerPresident Jan 23, 2023
W-2 Managing EmployeePresident Jan 23, 2023
Kerry L Heinrich Individual Corporate OfficerBoard of Director Dec 31, 2019
John H Cress Individual Corporate DirectorBoard Director Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Dec 31, 2019
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Heidar Thordarson Individual Corporate OfficerTreasurer Jan 6, 2025
Richard K Reiner Individual Corporate OfficerBoard of Director Dec 31, 2019
Joy a. Fehr Individual Corporate Director Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard Director Jan 1, 2024
Andrew R Davis Individual Corporate OfficerBoard of Director Dec 31, 2019
Ann K Beckett Individual Corporate DirectorBoard of Director Jan 1, 2024
Marc K Woodson Individual Corporate OfficerBoard of Director Dec 31, 2019
John C Freedman Individual Corporate OfficerBoard of Director Dec 31, 2019
Jack W Wagner Individual Corporate Director Dec 1, 2022
Kenneth Jutzy Individual Corporate Director Jan 1, 2024
Bradford C Newton Individual Corporate Director Aug 16, 2021
Robert a Cherry Individual Corporate OfficerBoard of Director Dec 31, 2019
Larry L Innocent Individual Corporate OfficerBoard of Director Dec 31, 2019

Owners & managing parties with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1639207343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GARCES HWY",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932153690",
            "telephone_number": "661-725-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 7TH ST",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801585",
            "telephone_number": "661-758-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH DELANO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JOBE",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "916-406-1576"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "120000180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP08539F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08539F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2300 7th St",
            "city": "Wasco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932801585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wasco Medical Plaza",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wasco Medical Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasco, CA

Sources for this page

Verify at the official NPI Registry.