NPIMap

Organization Active NPI

Oroville Hospital

Doing business as Premier Health Practice

  • Rural Health Clinic/Center
  • Oroville, CA
National Provider Identifier
1659849529
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OROVILLE HOSPITAL
Doing business as
Premier Health Practice
Practice address
3579 Oro Dam Blvd E Ste a&B
Oroville, CA 95966-5200
Phone
(530) 533-8500
NPI assigned
Nov 8, 2018
Last updated
Dec 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Colleen Sue Duncan
Title
Cfo
Phone
(560) 532-8509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

3579 Oro Dam Blvd E Ste a&B
Oroville, CA 95966-5200

Mailing address

2767 Olive Hwy
Oroville, CA 95966-6118
Phone (530) 533-8500

Other names 1

  • Premier Health Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181128003225 CA Part A Provider - Rural Health Clinic 1254234339 Practice locations: Oroville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659849529. Details of each certification follow.

Rural health clinic certification: CCN 058711

Legal name
OROVILLE HOSPITAL
Doing business as
PREMIER HEALTH PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 23, 2019
Last certification
Oct 23, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 18, 1985 in CA
Enrollment address
3579 Oro Dam Blvd Ste a & B
Oroville, CA 95986
Related CCNs
050030

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

Other NPIs with the same Medicare PAC ID 13

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

View all 13

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
05D2171290Premier Health Practice3579 Oro Dam Road, Oroville, CA 95966Certificate of waiverAug 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Thomas R Newlandercrna34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

3579 Oro Dam Blvd E
Ste Ab
Oroville, CA 95966

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Colleen Sue Duncan Individual Corporate OfficerCfo Dec 31, 2019
Corporate DirectorCfo Dec 31, 2019
W-2 Managing EmployeeCfo Feb 2, 2009
Robert J Wentz Individual Corporate OfficerCeo/President Mar 1, 2004 100%
Corporate DirectorCeo/President Mar 1, 2004 100%
W-2 Managing EmployeeCeo/President Mar 1, 2004 100%
Operational/Managerial ControlCeo/President Mar 1, 2004
Matthew J Bazzani Individual Corporate OfficerBRD MBR Oct 14, 2014
Roy C Shannon Individual Corporate OfficerBRD MBR Sep 25, 2014
Sultan M Chopan Individual Corporate OfficerBRD MBR Sep 25, 2014
Margaret F Mallette Individual Corporate OfficerBRD MBR May 21, 2008
Jo L Dilbeck Individual Corporate OfficerChief Reimbursement Officer Sep 1, 2003
Edward R Gilbert Individual Corporate OfficerBRD MBR Sep 25, 2014
James H Moll Individual Corporate OfficerBRD MBR Sep 25, 2014
William N Morris Individual Corporate OfficerBRD MBR Sep 25, 2014

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Oroville Hospital Post Acute CenterOroville, CA, CCN 555281 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2019
Jan 1, 2019

Owned or controlled facilities with NPI records 1

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

  • Oroville Hospital

    dba Oroville Hospital Post-Acute Center

    • Skilled Nursing Facility
    • Oroville, CA
    • NPI 1427006485

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1659849529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 ORO DAM BLVD E STE A&B",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665200",
            "telephone_number": "530-533-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OROVILLE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "560-532-8509"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Health Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.