NPIMap

Organization Active NPI

Ampla Health

  • Federally Qualified Health Center (FQHC)
  • Chico, CA
National Provider Identifier
1881613669
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AMPLA HEALTH
Practice address
285 Cohasset Rd
Chico, CA 95926-5513
Phone
(530) 342-6065
NPI assigned
Jul 19, 2006
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Vicki L Chissie
Title
Billing Account Manager
Phone
(530) 751-3778

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

285 Cohasset Rd
Chico, CA 95926-5513

Mailing address

PO Box Ad
Yuba City, CA 95992-1396
Phone (530) 751-3778

Other identifiers 2

IdentifierTypeStateIssuer
550001829OtherCACALIF DEPT OF PUBLIC HEALTH
FHC70485FMedicaidCA

Other names 1

  • Ampla Health Family Dental & Medical Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225001116 CA Part B Supplier - Clinic/Group Practice 5092619270 Receives reassigned benefits from 154 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yuba City, CA; Chico, CA; Oroville, CA; Orland, CA; Olivehurst, CA; Los Molinos, CA; Hamilton City, CA; Gridley, CA…
O20241115003190 CA Part A Provider - Federally Qualified Health Center (FQHC) 5092619270 Practice locations: Chico, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881613669. Details of each certification follow.

Federally qualified health center certification: CCN A01900

Legal name
AMPLA HEALTH
Doing business as
AMPLA HEALTH FAMILY DENTAL & MEDICAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 15, 2024
Last certification
Nov 15, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1973 in CA
Enrollment address
285 Cohasset Rd
Chico, CA 95926-5513

Other NPIs with the same Medicare PAC ID 16

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

View all 16

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
Tax ID family
Richlands Family Health13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

555 Fremont St
#C
Colusa, CA 95932
Phone (530) 458-8635

1211 Cortina Dr
#C
Orland, CA 95963
Phone (530) 865-5544

1453 Downer St
Oroville, CA 95965
Phone (530) 534-7400

935 Market St
Ste A
Yuba City, CA 95991
Phone (530) 673-9420

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Vaishali Austin Individual Corporate DirectorBoard Member Feb 1, 2021
Kim D Owens Individual Corporate Director Apr 27, 2007
Benjamin H Flores Individual Corporate OfficerAuthorized Official Apr 1, 2009
Kathleen Rasciner Individual Corporate DirectorBoard Member May 28, 2024
Ernest Garcia Individual Corporate DirectorBoard Member Apr 1, 2015
Divinder K Bains Individual Corporate Director Mar 1, 2021
Mary Rodriguez Individual Corporate DirectorBoard Member May 28, 2024
Carlos Palacios Individual Corporate DirectorBoard Member May 1, 2017
Roberto B Gonzalez Individual Corporate DirectorBoard Member Apr 17, 2001
Mark a Lundberg Individual Corporate Director Apr 1, 2017
Teng Vang Individual Corporate DirectorBoard Member Jun 25, 2019
Joyce Pope Individual Corporate DirectorBoard Member Feb 1, 2020
Vicki L Chissie Individual W-2 Managing EmployeeDelegated Official Mar 19, 2012
Debbie D Porcayo Individual Corporate Director Oct 27, 2009
Wenceslao Vasquez Individual Corporate Director Jan 28, 2004

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 170

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 170

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1881613669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX AD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959921396",
            "telephone_number": "530-751-3778",
            "fax_number": "530-751-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 COHASSET RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959265513",
            "telephone_number": "530-342-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "CHISSIE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING ACCOUNT MANAGER",
        "authorized_official_telephone_number": "530-751-3778"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF DEPT OF PUBLIC HEALTH",
            "identifier": "550001829",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70485F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ampla Health Family Dental & Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.