Ridgecrest Regional Hospital
Organization Active NPI Skilled Nursing Facility · Ridgecrest, CA
NPI 1669734653 · NPPES record last updated Sep 4, 2024
Key facts
- NPI
- 1669734653
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- RIDGECREST REGIONAL HOSPITAL
- Practice address
- 1131 N China Lake Blvd
Ridgecrest, CA 93555-3131 - Phone
- (760) 446-3591
- Fax
- (760) 446-2452
- NPI assigned
- Jun 14, 2012
- Organization subpart
- No
Authorized official
- Name
- James Suver
- Title
- Ceo
- Phone
- (760) 499-3900
Owners & managing parties with NPI records 1
Owned or controlled facilities with NPI records 5
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 10
Practitioners 94
-
Shahryar Ahmadi, MD
-
Janine Arbelaez, PSY.D
-
Ihab Edward Beblawi, M.D.
-
Alan Russell Bowles, LVN
-
Azadeh Brumand, D.O.
-
Arjun Chandrasekaran, M.D.
-
Patrick D Cichon, MD
-
Sharon Denise Clay Matemavi, NURSE PRACTITIONER
-
Matthew Thomas Cote, M.D.
-
Ernest V. De Guzman, M.D.
-
Healthy Jayantilal Desai, M.D.
-
Udaya Desilva, M.D.
-
Elodi Joy Dielubanza, M.D.
-
Vu Dinh, D.O.
-
Kelly Ann Doty, PA
Medicare Care Compare: Nursing home
- Listed as
- Ridgecrest Regional Transitional Care and Rehabili
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Sep 11, 2012
- Medicare certification status
- Active
- Certified beds
- 124 · 78.3 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $27,716
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0725430 | Bella Sera | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Skilled nursing facility certification: CCN 555877
- Legal name
- RIDGECREST REGIONAL HOSPITAL
- Doing business as
- RIDGECREST REGIONAL TRANSITIONAL CARE AND REHABILITATION UNIT
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 11, 2012
- Last certification
- Mar 6, 2025
- Beds
- 124
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 24, 1962 in CA
- Enrollment address
- 1081 N China Lake Blvd
Ridgecrest, CA 93555-3130 - Nursing home name
- RIDGECREST REGIONAL TRANSITIONAL CARE AND REHABILI
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Christopher Ellis |
Corporate Director |
May 1, 2021 | |
| Judith Tharp |
Corporate Director |
May 1, 2022 | |
| Dana Lyons |
Corporate Director | May 1, 2018 | 5% |
| James a Suver |
Corporate Officer |
Feb 17, 2009 | 100% |
| Operational/Managerial Control |
Feb 17, 2009 | 100% | |
| Lawrence N Cosner |
Corporate Director |
May 1, 2023 | |
| Kimberly a Lock |
Operational/Managerial Control | Dec 2, 2015 | |
| James Rizzardini |
Corporate Director | May 1, 2019 | 5% |
| Shrooq Abu-Issa |
Corporate Director |
May 1, 2021 | |
| Anita L Read |
Corporate Director | May 1, 2017 | 5% |
| Margaret M Hannon |
Corporate Director | May 1, 2017 | 5% |
| George Haslam |
Corporate Director | May 1, 2016 | 5% |
| Martha Hoppus |
Corporate Director |
May 1, 2022 | |
| Paige Sorbo |
Corporate Director |
May 1, 2017 | 5% |
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Ridgecrest Regional Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 11, 2012 |
| Ridgecrest Obstetrics Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 17, 2016 |
| RRH Mobile Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 29, 2016 |
| Southern Sierra Medical Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jun 1, 2019 |
| China Lake Community Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jun 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130425000504 | CA | Part a Provider - Skilled Nursing Facility | 9739099896 | Practice locations: Ridgecrest, CA |
National Provider Directory
- Tax ID family
- Ridgecrest Comm Hosp Phcy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1131 N China Lake Blvd
Ridgecrest, CA 93555-3131
Mailing address
1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 446-3551
Other practice location 1
1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 446-3551
Other names
- TCRU/BELLA SERA
Other providers in Ridgecrest, CA
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
All providers in Ridgecrest, CA · Skilled Nursing Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.