NPIMap

Organization Active NPI

Mountain Communities Healthcare District

Doing business as Trinity Hospital

  • Critical Access Hospital
  • Weaverville, CA
National Provider Identifier
1750462271
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
230000038 Issued in CA
Legal business name
MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT
Doing business as
Trinity Hospital
Practice address
60 Easter Avenue
Weaverville, CA 96093-1229
Phone
(530) 623-5541
Fax
(530) 623-3920
NPI assigned
Oct 18, 2006
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Kelly Simpson
Title
Director of Revenue Cycle
Phone
(530) 623-5541

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 230000038 CA
Rural Health Clinic/Center 261QR1300X 230000038 CA
Critical Access Hospital 282NC0060X 230000038 CA Primary
Skilled Nursing Facility 314000000X 230000038 CA
Land Ambulance 3416L0300X

Addresses

Primary practice location

60 Easter Avenue
Weaverville, CA 96093-1229

Mailing address

P.O. Box 1229
Weaverville, CA 96093-1229
Phone (530) 623-5541

Other identifiers 2

IdentifierTypeStateIssuer
HSP30392HMedicaidCA
HSP40392HMedicaidCA

Other names 1

  • Trinity Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070613000851 CA Part A Provider - Critical Access Hospital 9133227135 Receives reassigned benefits from 118 practitioners
Practice locations: Weaverville, CA
O20070613000853 CA Part A Provider - Rural Health Clinic 9133227135 1 other NPI on this enrollment
Practice locations: Weaverville, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1750462271. Details of each certification follow.

Hospital certification: CCN 051315

Legal name
MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT
Doing business as
TRINITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2004
Last certification
May 18, 2023
Beds
25
Ownership / control type
Hospital district or authority
Most recent change of ownership
Jul 1, 2007 (1 total)
Organization structure
GovernmentProprietary
Enrollment address
60 Easter Avenue
Weaverville, CA 96093-1229
Other Hospital Practice Location

Rural health clinic certification: CCN 058618

Legal name
MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT
Doing business as
TRINITY COMMUNITY HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 6, 2006
Last certification
Aug 29, 2018
Ownership / control type
Non-profit – church related
Most recent change of ownership
Jul 1, 2007 (1 total)
Organization structure
OtherProprietary
Incorporated
Aug 10, 2007 in CA
Enrollment address
31 Easter Ave
Weaverville, CA 96093-1229
Related CCNs
051315

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

Other NPIs with the same Medicare PAC ID 3

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

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
Trinity HospitalCCN 051315 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Kelly J Simpson Individual W-2 Managing EmployeeDirector of Revenue Cycle Nov 9, 2009
Paul Hauser Individual Corporate DirectorBoard Member May 30, 2018 20%
Corporate Director May 30, 2018
Aaron Rogers Individual Corporate OfficerChief Executive Officer Feb 10, 2015 20%
W-2 Managing EmployeeChief Executive Officer Feb 10, 2015 20%
W-2 Managing EmployeeChief Executive Officer Feb 10, 2015
Sheree Beans Individual Corporate DirectorBoard Member Mar 25, 2019 20%
Corporate Director Mar 25, 2019
Paul Catanese Individual Corporate DirectorBoard Member Dec 31, 2018 20%
Corporate Director Dec 31, 2018
Dero Forslund Individual Corporate DirectorBoard Member Dec 3, 2014 20%
Bettina Blackwell Individual Corporate Director Jul 25, 2018

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Trinity Hospital Swing BedWeaverville, CA, CCN 05Z315 Hospital Operational/Managerial Control Jul 1, 2007
Trinity Hospital Skilled Nursing FacilityWeaverville, CA, CCN 555907 Skilled nursing facility Operational/Managerial Control Jan 26, 2017
Hayfork Community Health ClinicHayfork, CA, CCN 058646 Rural health clinic Operational/Managerial Control (100%) Dec 31, 2008

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 139

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 139

Affiliated clinicians 84

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

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1750462271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1229",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "960931229",
            "telephone_number": "530-623-5541",
            "fax_number": "530-623-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EASTER AVENUE",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "960931229",
            "telephone_number": "530-623-5541",
            "fax_number": "530-623-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "530-623-5541"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "230000038",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "230000038",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "230000038",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000038",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30392H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40392H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weaverville, CA

Sources for this page

Verify at the official NPI Registry.