RIDGECREST REGIONAL HOSPITAL (NPI# 1639448400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639448400 |
| Entity Type | Organization |
| Organization Name | RIDGECREST REGIONAL HOSPITAL |
| Other Organization Name | CHINA LAKE COMMUNITY HEALTH CLINIC |
| Practice Address |
1041 N. China Lake Blvd. Ridgecrest CA 93555-3130 |
| Mailing Address |
1081 N. China Lake Blvd. Ridgecrest CA 93555-3130 |
| Practice Telephone | 7604463551 |
| Practice Fax Number | 7604462254 |
| Mailing Telephone | 7604463551 |
| Mailing Fax Number | 7604462254 |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2020-09-15 |
| Authorized Official Name | KIMBERLY ANN LOCK (REVENUE INTEGRITY ANALYST) |
| Authorized Official Telephone | 7604993899 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
550002085 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| China Lake Community Clinic | Doing Business As Name - Organization |
| China Lake Community Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699398560 | Ridgecrest Regional Hospital | Ambulance | 350 E Ridgecrest Blvd Ste 107, Ridgecrest, CA 93555-3928 | 2020-05-26 |
| 1164067971 | Ridgecrest Regional Hospital | Surgery | 1111 N China Lake Blvd Ste 220, Ridgecrest, CA 93555-3131 | 2019-11-15 |
| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| 1225363468 | Ridgecrest Regional Hospital | Hospice Care, Community Based | 1653 Triangle Dr Ste 200, Ridgecrest, CA 93555-2614 | 2009-10-06 |
| 1790811289 | Ridgecrest Regional Hospital | Pharmacy | 1109 N China Lake Blvd, Ridgecrest, CA 93555-3131 | 2007-02-26 |
| 1427043157 | Ridgecrest Regional Hospital | Home Health | 1653 Triangle Dr, Ridgecrest, CA 93555-2614 | 2005-09-19 |
| 1447253125 | Ridgecrest Regional Hospital | Emergency Medicine | 1081 N China Lake Blvd, Ridgecrest, CA 93555-3130 | 2005-05-24 |
| 1710545249 | Ridgecrest Regional Hospital | Chiropractor | 840 N Norma St Ste B, Ridgecrest, CA 93555-3570 | 2019-05-30 |
| 1730544313 | Ridgecrest Regional Hospital | General Acute Care Hospital | 1011 N China Lake Blvd, Ridgecrest, CA 93555-3130 | 2015-12-23 |
| 1407231210 | Ridgecrest Regional Hospital | General Acute Care Hospital | 1111 N China Lake Blvd, Ridgecrest, CA 93555-3131 | 2015-07-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RIDGECREST REGIONAL HOSPITAL | 1081 N China Lake Blvd, Ridgecrest, CA 93555-3130 |
| Street Address |
1041 N. CHINA LAKE BLVD. |
| City | RIDGECREST |
| State | CA |
| Zip Code | 93555-3130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321776 | Patrick Joseph Mccammon | Case Manager/Care Coordinator | 1400 N Norma, Ste 127, Ridgecrest, CA 93555 | 2019-11-25 |
| 1780170704 | Krista Mae Sanchez Tizon | Behavior Technician | 123 Grande Way, Suite B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1245726348 | Shinta Desentia Fraya | Behavior Technician | 123 Grande Way Ste B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1780114397 | Darci Turner | Occupational Therapy Assistant | 4309 W Weiman, Ridgecrest, CA 93555 | 2017-06-15 |
| 1700319407 | Telecare Corporation | Clinic/Center | 1141 Chelsea Street, Ridgecrest, CA 93555 | 2017-04-10 |
| 1245776236 | Katherine Gerow | Prevention Professional | 1131 Inyokern Rd, Ridgecrest, CA 93555 | 2017-01-13 |
| 1639552151 | Max Scott Higa | Social Worker | 1400 North Norma Street, Suite 133, Ridgecrest, CA 93555 | 2015-07-01 |
| 1184044703 | Ridgecrest Charter School | Speech-Language Pathologist | 325 S. Downs St., Ridgecrest, CA 93555 | 2014-04-22 |
| 1023366838 | Andrew Whalley | Occupational Therapist | 901 N.heritage Dr., Suite 106, Ridgecrest, CA 93555 | 2012-08-28 |
| 1831453026 | Andrew S Peters | Family Medicine | 1 Administration Circle, Stop 1311, Branch Clinic China Lake, Bldg 1403, Ridgecrest, CA 93555 | 2012-07-02 |
| Find all providers in zip 93555 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | RIDGECREST |
| Zip Code | 93555 |
Please comment or provide details below to improve the information on RIDGECREST REGIONAL HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.