NPIMap

Organization Active NPI

Clinicas de Salud del Pueblo, Inc

Doing business as Innercare

  • Federally Qualified Health Center (FQHC)
  • Niland, CA
National Provider Identifier
1679654750
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
090000456 Issued in CA
Legal business name
CLINICAS DE SALUD DEL PUEBLO, INC
Doing business as
Innercare
Innercare - Niland
Niland Health Clinic
Practice address
8027 US Hwy 111
Niland, CA 92257
Phone
(760) 359-0110
Fax
(760) 359-3629
NPI assigned
Oct 17, 2006
Last updated
Feb 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Ms. Yvonne Bell, MBA
Title
Ceo
Phone
(760) 344-9951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 090000456 CA Primary

Addresses

Primary practice location

8027 US Hwy 111
Niland, CA 92257

Mailing address

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 344-9951

Other identifiers 3

IdentifierTypeStateIssuer
HAP70526FOtherCAFAMILY PACT
FHC70526FMedicaidCA
BCP70526FOtherCACANCE DETECTION PROGRAM

Other names 3

  • Innercare Doing business as
  • Innercare - Niland Doing business as
  • Niland Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040123000573 CA Part A Provider - Federally Qualified Health Center (FQHC) 5496657082 Practice locations: Niland, CA
O20071201000158 CA Part B Supplier - Clinic/Group Practice 5496657082 Receives reassigned benefits from 148 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winterhaven, CA; Salton City, CA; Niland, CA; Mecca, CA; Indio, CA; El Centro, CA; Hemet, CA; Blythe, CA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679654750. Details of each certification follow.

Federally qualified health center certification: CCN 051952

Legal name
CLINICAS DE SALUD DEL PUEBLO INC
Doing business as
NILAND HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 20, 1970 in CA
Enrollment address
8027 Hwy 111
Niland, CA 92257-0268

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clinica de Salubridad de17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Shirley Chronister Individual Corporate DirectorBoard Member Jan 1, 2011
Leticia de Lara Individual Corporate DirectorBoard Member Jan 1, 2017
Raymond Leon Individual Corporate DirectorBoard Member Jan 1, 2012
Elizabeth Moreno Individual Corporate DirectorBoard Member Jan 1, 2007
Yvonne W Bell Individual Corporate OfficerPresident/Ceo Apr 15, 2014
W-2 Managing EmployeeCeo Apr 15, 2014
Isidoro Romero Individual Corporate DirectorBoard Member Jan 1, 2011
Maria D Lopez Individual Corporate DirectorBoard Member Jan 1, 2015
Nidia Carranza Individual Corporate DirectorBoard Member Jan 1, 2010

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1679654750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 E DANENBERG DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "92243",
            "telephone_number": "760-344-9951",
            "fax_number": "760-344-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8027 US HWY 111",
            "city": "NILAND",
            "state": "CA",
            "postal_code": "92257",
            "telephone_number": "760-359-0110",
            "fax_number": "760-359-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAS DE SALUD DEL PUEBLO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-344-9951",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "090000456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT",
            "identifier": "HAP70526F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70526F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CANCE DETECTION PROGRAM",
            "identifier": "BCP70526F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innercare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innercare - Niland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Niland Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niland, CA

Sources for this page

Verify at the official NPI Registry.