NPIMap

Organization Active NPI

Ridgecrest Regional Hospital

  • Land Ambulance
  • Ridgecrest, CA
National Provider Identifier
1699398560
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
RIDGECREST REGIONAL HOSPITAL
Practice address
350 E Ridgecrest Blvd Ste 107
Ridgecrest, CA 93555-3928
Phone
(760) 375-6531
NPI assigned
May 26, 2020
Last updated
May 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Authorized official

Name
Kimberly Ann Lock
Title
Provider Enrollment
Phone
(760) 499-3899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

350 E Ridgecrest Blvd Ste 107
Ridgecrest, CA 93555-3928

Mailing address

PO Box 157
Ridgecrest, CA 93556-0157

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.sophos.com/security/sophoslabs/spx.html

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130222000145 CA Part A Provider - Critical Access Hospital 9739099896 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ridgecrest, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699398560. Details of each certification follow.

Hospital certification: CCN 051333

Legal name
RIDGECREST REGIONAL HOSPITAL
Doing business as
RIDGECREST REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 8, 2012
Last certification
Feb 17, 2022
Beds
72 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 24, 1962 in CA
Enrollment address
1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Other Hospital Practice Location

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ridgecrest Regional HospitalCCN 051333 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Ridgecrest Comm Hosp Anesth11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Christopher Ellis Individual Corporate DirectorBoard Member May 1, 2021
Judith Tharp Individual Corporate DirectorBoard Member May 20, 2022
Dana Lyons Individual Corporate DirectorBoard Member May 1, 2018
James a Suver Individual Corporate OfficerCeo Feb 17, 2009
Operational/Managerial ControlCeo Feb 17, 2009 100%
James Rizzardini Individual Corporate DirectorBoard Member May 1, 2019
Shrooq Abu-Issa Individual Corporate DirectorBoard Member May 1, 2021
Anita L Read Individual Corporate DirectorBoard Member May 1, 2017
Margaret M Hannon Individual Corporate DirectorBoard Member May 1, 2017
George Haslam Individual Corporate DirectorChairman of the Board May 1, 2016
Martha Hoppus Individual Corporate DirectorBoard Member May 20, 2022
Paige Sorbo Individual Corporate DirectorBoard Member May 1, 2017
Adan Martinez Gonzalez Individual Operational/Managerial ControlOperations Manager Apr 19, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 265

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 265

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1699398560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935560157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E RIDGECREST BLVD STE 107",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553928",
            "telephone_number": "760-375-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "760-499-3899"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.sophos.com/security/sophoslabs/spx.html",
            "affiliation": "N",
            "address_1": "350 E Ridgecrest Blvd Ste 107",
            "city": "Ridgecrest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935553928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

Verify at the official NPI Registry.