NPIMap

Organization Active NPI

Sonora Community Hospital

Doing business as Long Term Care

  • Skilled Nursing Facility
  • Sonora, CA
National Provider Identifier
1801887401
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SONORA COMMUNITY HOSPITAL
Doing business as
Long Term Care
Practice address
1000 Greenley Rd
Sonora, CA 95370-5200
Phone
(209) 536-3859
Fax
(209) 533-7696
NPI assigned
Nov 2, 2005
Last updated
Apr 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SONORA COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Authorized official

Name
Andrew D. Jahn
Title
Vice President for Finance
Phone
(209) 536-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1000 Greenley Rd
Sonora, CA 95370-5200

Mailing address

14542 Lolly LN
Sonora, CA 95370-9226
Phone (209) 536-3900

Other names 1

  • Long Term Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100104000085 CA Part A Provider - Skilled Nursing Facility 4284538505 Practice locations: Sonora, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801887401. Details of each certification follow.

Skilled nursing facility certification: CCN 555209

Legal name
SONORA COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH SONORA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 7, 1985
Last certification
May 9, 2024
Beds
68
Ownership / control type
Church Related
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1958 in CA
Enrollment address
179 Fairview LN
Sonora, CA 95370-4809
Nursing home name
ADVENTIST HEALTH SONORA - D/P SNF
Affiliated entity
ADVENTIST HEALTH

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Adventist Health Sonora - D/P SNFCCN 555209 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Oct 7, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6862.7 residents per day on average
Chain
Adventist Health5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Sonora Community7 organizations share this tax ID, including this one
Part of
Sonora Community

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Melody L Gabriel Individual Corporate DirectorBoard Member Jun 1, 2015
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 15, 2015
James E Pedersen Individual Corporate DirectorBoard Member Jan 16, 2017
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Ricardo B Graham Individual Corporate DirectorBoard Member Jun 1, 2015
Andrew D Jahn Individual Corporate OfficerPresident Feb 3, 2014
W-2 Managing EmployeePresident/Ceo Aug 8, 2011
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Billy D Wing Individual Corporate OfficerVice Chair/Asst Secretary Mar 31, 2014
Corporate DirectorVice Chair/Asst Secretary Mar 31, 2014
Wesley E Rippey Individual Corporate DirectorBoard Member Jun 1, 2015
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Gregory D McCulloch Individual Contracted Managing EmployeeFinance Officer May 5, 2014
Corporate OfficerFinance Officer May 5, 2014
W-2 Managing EmployeeFinance Officer May 5, 2014
Jack W Wagner Individual Corporate OfficerAsst Secretary Mar 31, 2014
Brian S Reiner Individual Corporate OfficerChairman of Board Mar 14, 2014
Corporate DirectorChairman of Board May 13, 2011
Larry L Innocent Individual Corporate DirectorBoard Member Jun 1, 2015
Adventist Health System/West Organization, Roseville, CA Non-profit Operational/Managerial Control Jun 16, 1980 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 105

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

View all 105

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1801887401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14542 LOLLY LN",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709226",
            "telephone_number": "209-536-3900",
            "fax_number": "209-533-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREENLEY RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705200",
            "telephone_number": "209-536-3859",
            "fax_number": "209-533-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORA COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SONORA COMMUNITY HOSPITAL",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "JAHN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE",
        "authorized_official_telephone_number": "209-536-5011"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.