NPIMap

Organization Active NPI

Adventist Health Medical Center Tehachapi

Doing business as Adventist Health Community Care - California City

  • Rural Health Clinic/Center
  • California City, CA
National Provider Identifier
1699084525
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI
Doing business as
Adventist Health Community Care - California City
Practice address
9350 N Loop Blvd
California City, CA 93505-2269
Phone
(661) 823-1622
Fax
(661) 823-1594
NPI assigned
Sep 27, 2010
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Jason Wells
Title
President
Phone
(661) 863-3180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Critical Access Hospital 282NC0060X 120000188 CA

Addresses

Primary practice location

9350 N Loop Blvd
California City, CA 93505-2269

Mailing address

PO Box 845755
Los Angeles, CA 90084-5755
Phone (661) 771-8600

Other identifiers 6

IdentifierTypeStateIssuer
RHM08620FMedicaidCA
RHM13977FMedicaidCA
ZZT40446FMedicaidCA
LTC30446FMedicaidCA
ZZT30446FMedicaidCA
RHM13979FMedicaidCA

Other names 1

  • Adventist Health Community Care - California City Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160830003022 CA Part A Provider - Rural Health Clinic 1456646629 Practice locations: California City, CA
O20170124000729 CA Part B Supplier - Clinic/Group Practice 1456646629 Receives reassigned benefits from 190 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: California City, CA; Mojave, CA; Tehachapi, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699084525. Details of each certification follow.

Rural health clinic certification: CCN 058620

Legal name
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI
Doing business as
ADVENTIST HEALTH COMMUNITY CARE - CALIFORNIA CITY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 18, 2006
Last certification
Sep 6, 2017
Ownership / control type
2B
Most recent change of ownership
Nov 1, 2016 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Feb 10, 2016 in CA
Enrollment address
9350 N Loop Blvd
California City, CA 93505-2269
Related CCNs
051301

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).

Other NPIs on the same Medicare enrollment 4

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

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
05D1058166Adventist Health Community Care9350 North Loop Blvd, California City, CA 93505Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory

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
Jason Wells Individual Corporate OfficerPresident Jan 23, 2023
W-2 Managing Employee Jan 23, 2023
Kerry L Heinrich Individual Corporate OfficerChair Jan 1, 2022
Corporate DirectorBoard of Director Mar 29, 2016
John H Cress Individual Corporate DirectorBoard of Director Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Feb 10, 2016
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Heidar Thordarson Individual Corporate OfficerTreasurer Jan 6, 2025
Richard K Reiner Individual Corporate DirectorBoard of Director Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard of Director Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard of Director Jan 1, 2024
Andrew R Davis Individual Corporate DirectorBoard of Director May 5, 2017
Ann K Beckett Individual Corporate DirectorBoard of Director Jan 1, 2024
Marc K Woodson Individual Corporate DirectorBoard of Director Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard of Director Sep 26, 2016
Jack W Wagner Individual Corporate OfficerCfo Feb 10, 2016
W-2 Managing EmployeeCfo Feb 10, 2016
Kenneth Jutzy Individual Corporate DirectorBoard of Director Jan 1, 2024
Bradford C Newton Individual Corporate DirectorBoard of Director Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard of Director May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Mar 29, 2016
Adventist Health System/West Organization, Roseville, CA Non-profit Operational/Managerial Control Feb 10, 2016 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 105

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

View all 105

Change-of-ownership history 2

DateEventCounterparty
Nov 1, 2016 Change of OwnershipThis provider was the buyer Tehachapi Family Health Center-California CityCCN 058620, CA, NPI 1699084525
Nov 1, 2016 Change of OwnershipThis provider was the seller Adventist Health Community Care - California CityCCN 058620, CA, NPI 1699084525

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1699084525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845755",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845755",
            "telephone_number": "661-771-8600",
            "fax_number": "661-771-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 N LOOP BLVD",
            "city": "CALIFORNIA CITY",
            "state": "CA",
            "postal_code": "935052269",
            "telephone_number": "661-823-1622",
            "fax_number": "661-823-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-863-3180"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "120000188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08620F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM13977F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40446F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC30446F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30446F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM13979F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Community Care - California City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Community Care - California City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in California City, CA

Sources for this page

Verify at the official NPI Registry.