NPIMap

Organization Active NPI

Ukiah Adventist Hosptial

  • Rural Health Clinic/Center
  • Ukiah, CA
National Provider Identifier
1780754374
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
110000095 Issued in CA
Legal business name
UKIAH ADVENTIST HOSPTIAL
Practice address
1165 S Dora St
Suite B-1
Ukiah, CA 95482-8325
Phone
(707) 463-8000
Fax
(707) 462-1111
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Judson Howe
Title
President
Phone
(707) 456-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 110000095 CA Primary

Addresses

Primary practice location

1165 S Dora St
Suite B-1
Ukiah, CA 95482-8325

Mailing address

PO Box 888867
Los Angeles, CA 90088-8867

Other identifiers 1

IdentifierTypeStateIssuer
HSP40301FMedicaidCA

Other names 1

  • Adventist Health Ukiah Valley Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1780754374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888867",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 S DORA ST",
            "address_2": "SUITE B-1",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954828325",
            "telephone_number": "707-463-8000",
            "fax_number": "707-462-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UKIAH ADVENTIST HOSPTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "JUDSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-456-3010"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "110000095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40301F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Ukiah Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.