NPIMap

Organization Active NPI

Surprise Valley Health Care District

  • Critical Access Hospital
  • Cedarville, CA
National Provider Identifier
1801973052
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
230000025 Issued in CA
Legal business name
SURPRISE VALLEY HEALTH CARE DISTRICT
Practice address
741 Main & Washington
Cedarville, CA 96104-0246
Phone
(530) 279-6111
Fax
(530) 279-2680
NPI assigned
Nov 1, 2006
Last updated
Sep 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
Wanda L. Grove
Title
Administrator
Phone
(530) 279-6111

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 230000025 CA
Radiology Clinic/Center 261QR0200X 230000025 CA
General Acute Care Hospital 282N00000X 230000025 CA
Critical Access Hospital 282NC0060X 230000025 CA Primary
Clinical Medical Laboratory 291U00000X 230000025 CA
Land Ambulance 3416L0300X 230000025 CA

Addresses

Primary practice location

741 Main & Washington
Cedarville, CA 96104-0246

Mailing address

PO Box 246
741 North Main
Cedarville, CA 96104-0246
Phone (530) 279-6111

Other identifiers 3

IdentifierTypeStateIssuer
MTE00309FMedicaidCA
HSP30676FMedicaidCA
HSP40676FMedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050407000864 CA Part B Supplier - Clinic/Group Practice 1658368519 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Cedarville, CA
O20061104000300 CA Part A Provider - Critical Access Hospital 1658368519 Receives reassigned benefits from 5 practitioners
Practice locations: Cedarville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801973052. Details of each certification follow.

Hospital certification: CCN 051308

Legal name
SURPRISE VALLEY HEALTH CARE DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 2002
Last certification
Jun 12, 2025
Beds
4
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Nov 8, 1983 in CA
Enrollment address
741 N Main Street
Cedarville, CA 96104-0246
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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
Surprise Valley Community HospitalCCN 051308 · 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 2

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

NameRoleSinceShare
Patricia a Grove Individual W-2 Managing EmployeeOffice Manager Oct 22, 2014
Frances D Hannah Individual Corporate OfficerChief Executive Officer Aug 22, 2022 100%
W-2 Managing EmployeeChief Executive Officer Aug 23, 2022
Operational/Managerial ControlChief Executive Officer Aug 23, 2022 100%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Surprise Valley Community Hospital SwingCedarville, CA, CCN 05Z308 Skilled nursing facility Operational/Managerial Control (100%) Oct 22, 2014

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 11

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.

Affiliated clinicians 9

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1801973052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "address_2": "741 NORTH MAIN",
            "city": "CEDARVILLE",
            "state": "CA",
            "postal_code": "961040246",
            "telephone_number": "530-279-6111",
            "fax_number": "530-279-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 MAIN & WASHINGTON",
            "city": "CEDARVILLE",
            "state": "CA",
            "postal_code": "961040246",
            "telephone_number": "530-279-6111",
            "fax_number": "530-279-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE VALLEY HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "530-279-6111"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "CA",
            "license": "230000025",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "230000025",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "230000025",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "230000025",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "230000025",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CA",
            "license": "230000025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTE00309F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30676F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40676F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarville, CA

Sources for this page

Verify at the official NPI Registry.