NPIMap

Organization Active NPI

Reedley Community Hospital

Doing business as Adventist Health Reedley - Corcoran

  • Rural Health Clinic/Center
  • Corcoran, CA
National Provider Identifier
1881677292
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
040000140 Issued in CA
Legal business name
REEDLEY COMMUNITY HOSPITAL
Doing business as
Adventist Health Reedley - Corcoran
Practice address
1212 Hanna Ave
Corcoran, CA 93212-2313
Phone
(559) 992-2800
Fax
(559) 992-2899
NPI assigned
Nov 21, 2005
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Andrea Kofl
Title
Central Valley Network President
Phone
(559) 537-0056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 040000140 CA Primary

Addresses

Primary practice location

1212 Hanna Ave
Corcoran, CA 93212-2313

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (559) 537-2100

Other identifiers 3

IdentifierTypeStateIssuer
HAP08552FMedicaidCA
BCP08552FMedicaidCA
RHM08552FMedicaidCA

Other names 1

  • Adventist Health Reedley - Corcoran Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151117002152 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Corcoran, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881677292. Details of each certification follow.

Rural health clinic certification: CCN 058552

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 1, 1997
Last certification
Nov 7, 2017
Ownership / control type
2B
Most recent change of ownership
Dec 1, 2015 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2011 in CA
Enrollment address
1212 Hanna Ave
Corcoran, CA 93212-2313
Related CCNs
050192

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

National Provider Directory

National Provider Directory
Tax ID family
Reedley Community Hospital37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

1212 Hanna Ave
Corcoran, CA 93212
Phone (559) 992-2800

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jason Wells Individual Corporate OfficerPresident Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 14, 2015
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
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
Todd N Hofheins Individual Corporate OfficerVice Chair Jan 24, 2022
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
Timothy M Haydock Individual Corporate OfficerInterim Treasurer Jul 9, 2024
Jack W Wagner Individual Corporate OfficerAsst Secretary Mar 31, 2014
Kenneth Jutzy Individual Corporate DirectorBoard Member Jan 1, 2024
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Corporation, Non-profit Operational/Managerial Control Dec 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.

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 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1881677292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888806",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888806",
            "telephone_number": "559-537-2100",
            "fax_number": "559-537-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 HANNA AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932122313",
            "telephone_number": "559-992-2800",
            "fax_number": "559-992-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEDLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "KOFL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CENTRAL VALLEY NETWORK PRESIDENT",
        "authorized_official_telephone_number": "559-537-0056"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "040000140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP08552F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP08552F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08552F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Reedley - Corcoran",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corcoran, CA

Sources for this page

Verify at the official NPI Registry.