NPIMap

Organization Active NPI

Sutter Coast Hospital

Doing business as SCH Acute Rehab Center

  • Rehabilitation Hospital Unit
  • Crescent City, CA
National Provider Identifier
1720463391
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
SUTTER COAST HOSPITAL
Doing business as
SCH Acute Rehab Center
Practice address
800 E Washington Blvd
Crescent City, CA 95531-8359
Phone
(707) 464-8511
Fax
(707) 464-8941
NPI assigned
Jul 24, 2015
Last updated
Mar 15, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
SUTTER COAST HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Authorized official

Name
Mr. Mitch Hanna
Title
Ceo
Phone
(707) 464-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X CA Primary

Addresses

Primary practice location

800 E Washington Blvd
Crescent City, CA 95531-8359

Mailing address

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Other names 1

  • SCH Acute Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151029002599 CA Part A Provider - Hospital 9436148111 Practice locations: Crescent City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720463391. Details of each certification follow.

Hospital certification: CCN 05T417

Legal name
SUTTER COAST HOSPITAL
Doing business as
SCH ACUTE REHAB CENTER
Organization structure
CorporationNon-profit
Incorporated
May 23, 1985 in CA
Enrollment address
800 E Washington Blvd
Crescent City, CA 95531-8359
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Sutter Coast HospitalCCN 05T417 · All quality measures
Ownership
Government
Certified
Jan 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Anthony Demory MD5 organizations share this tax ID, including this one
Part of
Anthony Demory MD

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Patricia Piper Individual Corporate DirectorBoard Member Dec 1, 2018
Michael Lane Individual Corporate OfficerCeo Mar 1, 2024
Corporate DirectorBoard Member Feb 5, 2024
Ronnie Yamanaka Individual Corporate OfficerCfo Jan 4, 2024
W-2 Managing Employee Jan 4, 2024
John Pritchett Individual Corporate DirectorBoard Member Nov 1, 2023
Carroll C Christie Individual Corporate DirectorBoard Member Jan 1, 2019
Celia Perez Individual Corporate DirectorBoard Member Sep 1, 2021
Clarke Moore Individual Corporate DirectorBoard Member Aug 1, 2017
Ronald Sandler Individual Corporate DirectorBoard Member Feb 1, 2018
Sutter Health Organization, Sacramento, CA Non-profit 5% Or Greater Direct Ownership Interest Jan 31, 1986 100%
Roland Hart Individual Corporate DirectorBoard Member May 1, 2019

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sutter Coast Health CenterCrescent City, CA, CCN 058519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 31, 1986

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 59

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

View all 59

Practitioners & affiliated clinicians

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1720463391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318359",
            "telephone_number": "707-464-8511",
            "fax_number": "707-464-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318359",
            "telephone_number": "707-464-8511",
            "fax_number": "707-464-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER COAST HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER COAST HOSPITAL",
        "enumeration_date": "2015-07-24",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-464-8511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCH Acute Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.