NPIMap

Organization Active NPI

Shriners Hospitals for Children

  • Children's Hospital
  • Sacramento, CA
National Provider Identifier
1962530451
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
030000620 Issued in CA
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Practice address
2425 Stockton Blvd
Sacramento, CA 95817-2215
Phone
(916) 453-2000
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Jerry G. Gantt
Title
President
Phone
(813) 281-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 030000620 CA Primary

Addresses

Primary practice location

2425 Stockton Blvd
Sacramento, CA 95817-2215

Mailing address

PO Box 8500
Lockbox #7642
Philadelphia, PA 19178-7642
Phone (916) 453-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020000059 CA Part A Provider - Hospital 9133031933 Practice locations: Sacramento, CA

Hospital certification: CCN 053311

Legal name
SHRINERS HOSPITALS FOR CHILDREN
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Apr 18, 2011
Last certification
Jan 28, 2017
Beds
80
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 18, 1925 in CO
Enrollment address
2425 Stockton Blvd
Sacramento, CA 95817-2215
Other Hospital Practice Location
Hospital subgroups
Children’s

Care Compare: Hospital

Medicare Care Compare
Listed as
Shriners Hospitals for Children Northern CalifCCN 053311
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Shriners Hosp for Children49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
William B. Rasner Individual Corporate DirectorTrustee Jul 7, 2022
Jim L Cain Individual Corporate Director Aug 15, 2010
Matthew Sturlaugson Individual Corporate OfficerSecretary Jul 3, 2025
Corporate Director Jul 12, 2020
Lawrence J Leib Individual Corporate Officer1St Vice President Jul 3, 2025
Corporate Director Jul 13, 2017
Dale R. Vrsalovich Individual Corporate DirectorDirector Jul 4, 2024
Martin L. Bartlett Individual Corporate OfficerAssistant Secretary Jul 3, 2025
Corporate Director Jul 8, 2021
John P McCabe Individual W-2 Managing Employee Aug 15, 2010
Ronald Capps Individual Corporate DirectorTrustee Jul 4, 2024
Phillip L Grady Individual W-2 Managing EmployeeVP Hospital Operations Sep 1, 2019
Dennis W. Hewatt Individual Corporate DirectorTrustee Jul 3, 2025
David C. Hamm Individual Corporate Director Jul 6, 2023
Scott Allen Schuster Individual Corporate OfficerTreasurer Jul 3, 2025
Corporate Director Jul 3, 2025
John Pawlek Individual W-2 Managing EmployeeAdministrator Nov 7, 2022
Timothy L. Ludwig Individual Corporate DirectorTrustee Jul 6, 2023
Ricky Holloway Individual Corporate Director Jul 3, 2025
Robyn M Bartlett Individual W-2 Managing EmployeeDirector of Patient Care Services Apr 17, 2023
Adam Woods Individual W-2 Managing EmployeeDirector Fiscal Services Jun 14, 2022
Mark E Hartz Individual Corporate Officer2ND Vice President Jul 3, 2025
Corporate Director Jul 19, 2018
Leslie D Stewart Individual Corporate OfficerPresident Jul 4, 2024
Corporate Director Jul 7, 2016
Timothy D Forbis Individual Corporate Director Jul 8, 2021
Brad T Koehn Individual Corporate OfficerChairman, Board of Directors Jul 3, 2025
Corporate Director Jul 13, 2017
Kenneth G Craven Individual Corporate DirectorTrustee Jul 10, 2013
Ronald Devoll Individual Corporate Director Jul 7, 2022
Shriners Hospitals for Children Organization, Tampa, FL Non-profit 5% Or Greater Direct Ownership Interest Apr 15, 1997 100%
Operational/Managerial Control Apr 15, 1997
Richard G Burke Individual Corporate Director Jul 7, 2016

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 8

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

FacilityTypeRoleSince
Shriners Hospitals for ChildrenPhiladelphia, PA, CCN 393309 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 24, 1966
Jun 24, 1966
Shriners Hospitals for ChildrenPortland, OR, CCN 383300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 15, 1966
Jan 15, 2015
Shriners Hospitals for ChildrenGalveston, TX, CCN 453311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 1966
Mar 20, 1966
Shriners Hospitals for ChildrenHonolulu, HI, CCN 123301 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
Shriners Hospitals for ChildrenGreenville, SC, CCN 423300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 20, 2013
Jul 15, 2010
Shriners Children'S OhioDayton, OH, CCN 363308 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 19, 1968
Feb 19, 1968
Shriners Hospitals for ChildrenChicago, IL, CCN 143302 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966
Shriners Hospitals for ChildrenSaint Louis, MO, CCN 263304 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1962530451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "916-453-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "916-453-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-281-0300"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "CA",
            "license": "030000620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.