NPIMap

Organization Active NPI

Kaweah Delta Health Care District

Doing business as Kaweah Health Medical Clinic - Ben Maddox

  • Primary Care Clinic/Center
  • Visalia, CA
National Provider Identifier
1881984706
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
KAWEAH DELTA HEALTH CARE DISTRICT
Doing business as
Kaweah Health Medical Clinic - Ben Maddox
Practice address
1110 S Ben Maddox Way
Visalia, CA 93292-3643
Phone
(559) 624-4800
Fax
(559) 635-6100
NPI assigned
Apr 12, 2011
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
KAWEAH DELTA HEALTH CARE DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Malinda Tupper
Title
SRVP/Chief Financial Officer
Phone
(559) 624-4065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1110 S Ben Maddox Way
Visalia, CA 93292-3643

Mailing address

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2739

Other names 1

  • Kaweah Health Medical Clinic - Ben Maddox Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050408001146 CA Part B Supplier - Clinic/Group Practice 6608778790 Receives reassigned benefits from 118 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Visalia, CA
O20110914000795 CA Part B Supplier - Clinic/Group Practice 6608778790 Receives reassigned benefits from 204 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Visalia, CA; Los Angeles, CA; Bakersfield, CA; Hanford, CA; Irvine, CA; Long Beach, CA; Tulare, CA; Santa Barbara, CA

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2027993Kaweah Health Medical Group- Ben Maddox1110 S Ben Maddox Way, Suite B, Visalia, CA 93292Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory
Part of
Kaweah Delta Non Inv Ca

Locations

1110 S Ben Maddox Way
Visalia, CA 93292
Phone (559) 624-4800

301 W Noble Ave
Visalia, CA 93277
Phone (559) 624-6875

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.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1881984706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916237",
            "telephone_number": "559-624-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S BEN MADDOX WAY",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923643",
            "telephone_number": "559-624-4800",
            "fax_number": "559-635-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "enumeration_date": "2011-04-12",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "TUPPER",
        "authorized_official_first_name": "MALINDA",
        "authorized_official_title_or_position": "SRVP/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "559-624-4065"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaweah Health Medical Clinic - Ben Maddox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.