Centerwell Certified Healthcare Corp

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CENTERWELL CERTIFIED HEALTHCARE CORP

Practice address

5341 Old Redwood Hwy Ste 350
Petaluma, CA 94954-7127

Phone

(707) 545-7114

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

John Nichols

Title

Authorized Signatory

Phone

(707) 545-7114

Specialties & licenses 1

Addresses

Other identifiers 15

Other names 1

• CenterWell Home Health Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Greer Verson Bradley, O.T.

  • Occupational Therapist
  • Santa Rosa, CA
  • NPI 1114134533
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1700813615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SPRINT PKWY STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5341 OLD REDWOOD HWY STE 350",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949547127",
            "telephone_number": "707-545-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL CERTIFIED HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "707-545-7114"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-BLUE SHIELD",
            "identifier": "ZZZ34072Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "05-7036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "010000084",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333724",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "520121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "11-3414024",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "564478",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "5868461",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "057036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR07036H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "013100P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "106825024",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "113414024",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "565800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "GA0699",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CenterWell Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lin Cedergren
• Steven A Cefalu, LMFT
• Tiffany Jasmeen Ceja
• Ermal Eri Cela
• Kristen Michelle Celli
• Alejandra Cerna
• Guadalupe Chabriel, AGPCNP
• Adriana Chacon-Kreysa
• Aimee C Chagnon, MD
• Shannon Dawn Chain, MD

• Home Health Agency in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.