NPIMap

Organization Active NPI

Reedley Community Hospital

Doing business as Adventist Health Community Care - Coalinga

  • Rural Health Clinic/Center
  • Coalinga, CA
National Provider Identifier
1972586386
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 Community Care - Coalinga
Adventist Health Reedley - Coalinga
Practice address
155 S 5TH St
Coalinga, CA 93210-1903
Phone
(559) 587-4349
Fax
(559) 587-4366
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

155 S 5TH St
Coalinga, CA 93210-1903

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (559) 587-4349

Other identifiers 3

IdentifierTypeStateIssuer
HAP08596FMedicaidCA
BCP08596FMedicaidCA
RHM08596FMedicaidCA

Other names 2

  • Adventist Health Community Care - Coalinga Doing business as
  • Adventist Health Reedley - Coalinga Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151016002270 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Coalinga, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972586386. Details of each certification follow.

Rural health clinic certification: CCN 058596

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 30, 2003
Last certification
Mar 15, 2018
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
155 S 5TH St
Coalinga, CA 93210-1903
Related CCNs
050192

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

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
05D1017064Adventist Health Reedley155 S 5TH St, Coalinga, CA 93210Provider-performed microscopySep 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Adventist Medical Center Reedley37 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

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 EmployeeAd; Jan 1, 2024
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
John H Cress Individual Corporate DirectorCorporate Director Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Heidar Thordarson Individual Corporate OfficerTreasurer Jan 6, 2025
Richard K Reiner Individual Corporate DirectorCorporate Director Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorCorporate Director Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorCorporate Director Jan 1, 2024
Andrew R Davis Individual Corporate DirectorCorporate Director May 5, 2017
Ann K Beckett Individual Corporate DirectorCorporate Director Jan 1, 2024
Marc K Woodson Individual Corporate DirectorCorporate Director Jan 1, 2019
John C Freedman Individual Corporate DirectorCorporate Director Sep 26, 2016
Jack W Wagner Individual Corporate OfficerAsst Secretary Mar 31, 2014
Kenneth Jutzy Individual Corporate DirectorCorporate Director Jan 1, 2024
Bradford C Newton Individual Corporate DirectorCorporate Director Aug 16, 2021
Robert a Cherry Individual Corporate DirectorCorporate Director 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 Jan 1, 2012 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

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": "1972586386",
    "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": "559-587-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 S 5TH ST",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932101903",
            "telephone_number": "559-587-4349",
            "fax_number": "559-587-4366"
        }
    ],
    "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": "HAP08596F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP08596F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08596F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Community Care - Coalinga",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Community Care - Coalinga",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Reedley - Coalinga",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coalinga, CA

Sources for this page

Verify at the official NPI Registry.