NPIMap

Organization Active NPI

Lodi Memorial Hospital Association Inc

  • Rehabilitation Hospital Unit
  • Lodi, CA
National Provider Identifier
1821028671
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
030000056 Issued in CA
Legal business name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Practice address
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone
(209) 334-3411
NPI assigned
Jul 4, 2006
Organization subpart
Yes
Parent organization
LODI MEMORIAL HOSPITAL ASSOCIATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Authorized official

Name
Katie J Delmore
Title
Finance Officer
Phone
(209) 334-3411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 030000056 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
Lodi, CA 95240-5118

Mailing address

PO Box 884577
Los Angeles, CA 90088-4577
Phone (209) 334-3411

Other names 1

  • Lodi Memorial Hospital Acute Physical Rehabilitation Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061204000628 CA Part A Provider - Hospital 7618880717 Practice locations: Lodi, CA

Hospital certification: CCN 05T336

Legal name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
ADVENTIST HEALTH LODI MEMORIAL
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1945 in CA
Enrollment address
975 S Fairmont Ave
Lodi, CA 95240-5118
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Adventist Health Lodi MemorialCCN 05T336
Ownership
Non-profit
Certified
Jun 1, 1988

National Provider Directory

National Provider Directory
Tax ID family
Lodi Memorial Hosp9 organizations share this tax ID, including this one
Part of
Lodi Memorial Hosp

Other organizations with this tax ID 8

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

Locations

2700 F St
Ste 300
Bakersfield, CA 93301
Phone (661) 322-4902

387 Civic Dr
Galt, CA 95632
Phone (209) 745-8080

999 S Fairmont Ave
Ste 200
Lodi, CA 95240
Phone (209) 334-3333

945 S Fairmont Ave
Lodi, CA 95240

801 S Ham Ln
Ste J
Lodi, CA 95242
Phone (209) 369-7336

1150 S Cherokee Ln
Lodi, CA 95240
Phone (209) 370-1700

999 S Fairmont Ave
Ste 230
Lodi, CA 95240
Phone (209) 334-4924

1095 Marshall Way
Ste 202
Placerville, CA 95667
Phone (530) 626-3682

2 Medical Plaza Dr
Ste 250
Roseville, CA 95661
Phone (916) 786-3824

2633 Pacific Ave
Stockton, CA 95204
Phone (209) 944-5530

1503 E March Ln
Stockton, CA 95210
Phone (209) 462-7277

1020 Nut Tree Rd
#270
Vacaville, CA 95687
Phone (707) 646-4100

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Kerry L Heinrich Individual Corporate OfficerChair of Board Jan 1, 2022
Corporate DirectorBoard Member Jun 1, 2015
John H Cress Individual Corporate DirectorBoard Member Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Jun 1, 2015
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard Member Jan 1, 2024
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Ann K Beckett Individual Corporate DirectorBoard Member Jan 1, 2024
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Kenneth Jutzy Individual Corporate DirectorBoard Member Jan 1, 2024
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Katherine Delmore Individual Corporate OfficerTreasurer Sep 18, 2022 100%
W-2 Managing EmployeeFinance Officer Sep 18, 2022
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Jun 1, 2015
Brooke McCollough Individual Corporate OfficerPresident Aug 19, 2022 100%
Donovan Stewart Individual Corporate OfficerCno Jun 15, 2021
Adventist Health System/West Organization, Roseville, CA Non-profit Operational/Managerial Control Jun 1, 2015 100%

Owners & managing parties with NPI records 1

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
Adventist Health Lodi MemorialGalt, CA, CCN 058546 Rural health clinic Operational/Managerial Control (100%) May 16, 2013

Owned or controlled facilities with NPI records 1

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

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

Practitioners 176

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 176

Affiliated clinicians 7

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1821028671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 884577",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900884577",
            "telephone_number": "209-334-3411",
            "fax_number": "209-339-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LODI MEMORIAL HOSPITAL ASSOCIATION INC",
        "enumeration_date": "2006-07-04",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "DELMORE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "209-334-3411"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": "030000056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "975 S Fairmont Ave",
            "city": "Lodi",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952405118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lodi Memorial Hospital Acute Physical Rehabilitation Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lodi Memorial Hospital Acute Physical Rehabilitation Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.