NPIMap

Organization Active NPI

County of Tulare

Doing business as Farmersville Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
National Provider Identifier
1801831227
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF TULARE
Doing business as
Farmersville Health Care Center
Practice address
660 E Visalia Rd
Farmersville, CA 93223-1641
Phone
(559) 713-2890
Fax
(559) 594-6790
NPI assigned
Jun 19, 2006
Last updated
May 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Dr. Cheryl L Duerksen
Title
Agency Director
Phone
(559) 624-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

660 E Visalia Rd
Farmersville, CA 93223-1641

Mailing address

5957 S Mooney Blvd
Visalia, CA 93277-9394
Phone (559) 624-8000

Other identifiers 1

IdentifierTypeStateIssuer
FHC70782FMedicaidCA

Other names 1

  • Farmersville Health Care Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000821 CA Part B Supplier - Clinic/Group Practice 1456264555 Receives reassigned benefits from 89 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Visalia, CA; Tulare, CA; Porterville, CA; Farmersville, CA
O20110223000535 CA Part A Provider - Federally Qualified Health Center (FQHC) 1456264555 Practice locations: Farmersville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801831227. Details of each certification follow.

Federally qualified health center certification: CCN 551870

Legal name
COUNTY OF TULARE
Doing business as
TULARE COUNTY HEALTH AND HUMAN SERVICES AGENCY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 23, 2000
Last certification
Feb 23, 2000
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
660 E Visalia Rd
Farmersville, CA 93223-1641

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 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

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
County of Tulare Organization, Visalia, CA Other Apr 30, 2010
Staci Chastain Individual W-2 Managing EmployeeDeputy Director of Public Health May 1, 2018
Angie Tipton Individual W-2 Managing EmployeeDivision MGR of Fiscal Operations Apr 30, 2010
Karen Elliott Individual W-2 Managing Employee Apr 30, 2010

Owners & managing parties with NPI records 3

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
Tulare County Health and Human Services AgencyVisalia, CA, CCN 551814 Federally qualified health center Other (100%) Jan 1, 1976

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1801831227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932779394",
            "telephone_number": "559-624-8000",
            "fax_number": "559-737-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 E VISALIA RD",
            "city": "FARMERSVILLE",
            "state": "CA",
            "postal_code": "932231641",
            "telephone_number": "559-713-2890",
            "fax_number": "559-594-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF TULARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "DUERKSEN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "559-624-8000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70782F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmersville Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmersville, CA

Sources for this page

Verify at the official NPI Registry.