NPIMap

Organization Active NPI

Reedley Community Hospital

Doing business as Adventist Health Reedley - Shafter

  • Rural Health Clinic/Center
  • Shafter, CA
National Provider Identifier
1689037533
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
REEDLEY COMMUNITY HOSPITAL
Doing business as
Adventist Health Reedley - Shafter
Practice address
406 James St
Shafter, CA 93263-2035
Phone
(661) 746-5788
Fax
(661) 746-5273
NPI assigned
Mar 29, 2016
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Andrea Kofl
Title
Central Valley Network President
Phone
(559) 537-0056

Specialties & licenses 1

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

Addresses

Primary practice location

406 James St
Shafter, CA 93263-2035

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (661) 746-5788

Other names 1

  • Adventist Health Reedley - Shafter Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160610000492 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Shafter, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689037533. Details of each certification follow.

Rural health clinic certification: CCN 058691

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 30, 2016
Last certification
Jul 2, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2011 in CA
Enrollment address
406 James St
Shafter, CA 93263-2035
Related CCNs
050192

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

National Provider Directory

National Provider Directory
Tax ID family
Reedley Community Hospital37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

216 E Fresno St
Avenal, CA 93204
Phone (559) 386-4063

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 15, 2015
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Andrea S Kofl Individual Corporate OfficerPresident Feb 27, 2017
W-2 Managing EmployeePresident/Ceo Feb 27, 2017
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Todd N Hofheins Individual Corporate DirectorVice Chair Jan 24, 2022
Lucy a Ocampo Individual Corporate DirectorBoard Member Jul 1, 2019
David P Banks Individual Corporate DirectorBoard Member May 5, 2017
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Timothy M Haydock Individual Corporate OfficerTreasurer/Assistant Secretary Jul 3, 2017
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Corporation, Non-profit Operational/Managerial Control Aug 24, 2011 100%

Facilities with the same owner 105

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 105

Practitioners & affiliated clinicians

Practitioners 1

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": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1689037533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888806",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888806",
            "telephone_number": "661-746-5788",
            "fax_number": "661-746-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 JAMES ST",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632035",
            "telephone_number": "661-746-5788",
            "fax_number": "661-746-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEDLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "KOFL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CENTRAL VALLEY NETWORK PRESIDENT",
        "authorized_official_telephone_number": "559-537-0056"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Reedley - Shafter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shafter, CA

Sources for this page

Verify at the official NPI Registry.