NPIMap

Organization Active NPI

Colusa Medical Center, LLC

  • Rural Health Clinic/Center
  • Willows, CA
National Provider Identifier
1760272991
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COLUSA MEDICAL CENTER, LLC
Practice address
130 N Enright Ave
Willows, CA 95988-2716
Phone
(530) 934-1766
NPI assigned
May 9, 2025
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUSA MEDICAL CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Tammy Jean Thompson
Title
VP Finance/Cfo
Phone
(209) 287-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

130 N Enright Ave
Willows, CA 95988-2716

Mailing address

199 E Webster St
Colusa, CA 95932-0019

Other names 1

  • Glenn Family Medical Group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250811003594 CA Part A Provider - Rural Health Clinic 4183901978 Practice locations: Willows, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760272991. Details of each certification follow.

Rural health clinic certification: CCN 058572

Legal name
COLUSA MEDICAL CENTER, LLC
Doing business as
GLENN FAMILY MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 27, 2000
Last certification
Feb 9, 2017
Ownership / control type
2B
Most recent change of ownership
Jun 1, 2025 (3 total)
Organization structure
LLCProprietary
Enrollment address
130 N Enright Ave
Willows, CA 95988-2716

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

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Colusa Medical Center LLC10 organizations share this tax ID, including this one
Part of
Colusa Medical Center LLC

Other organizations with this tax ID 9

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Lovepreet Kaur Individual W-2 Managing EmployeeDirector of Clinic Services Jun 28, 2021
Operational/Managerial ControlDirector of Clinic Services Jun 28, 2021
Gurpreet Singh Randhawa Individual 5% Or Greater Indirect Ownership InterestOwner of Colusa Medical Center Aug 1, 2018 100%
Corporate OfficerBoard Member Aug 1, 2018
Colusa Medical Center, LLC Organization, Willows, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2025 100%
Tammy Thompson Individual Corporate DirectorCfo/VP Finance Aug 1, 2018

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 10

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

FacilityTypeRoleSince
Colusa Medical Center - AcuteColusa, CA, CCN 050783 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical Center-AcuteColusa, CA, CCN 05U783 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical Center - SNFColusa, CA, CCN 555909 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jan 1, 2019
Jun 27, 2018
Colusa Medical CenterWilliams, CA, CCN 058696 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical CenterArbuckle, CA, CCN 058695 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical CenterColusa, CA, CCN 058697 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical Center, LLCRed Bluff, CA, CCN 058722 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Colusa Medical Center, LLCOrland, CA, CCN 058720 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
First Care Medical AssociatesOrland, CA, CCN 058922 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Family Care CenterWillows, CA, CCN 053981 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2025

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 9

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

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2025 Change of OwnershipThis provider was the buyer Glenn Family Medical GroupCCN 058572, CA, NPI 1346283017

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1760272991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 E WEBSTER ST",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959320019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N ENRIGHT AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882716",
            "telephone_number": "530-934-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUSA MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUSA MEDICAL CENTER, LLC",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "VP FINANCE/CFO",
        "authorized_official_telephone_number": "209-287-6308"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenn Family Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Willows, CA

Sources for this page

Verify at the official NPI Registry.