ADVENTIST HEALTH LODI MEMORIAL
NPI 1164431383
Clinic/Center - Rural Health in Galt, CA

NPI Status: Active since August 05, 2006

Contact Information

387 CIVIC DR
GALT, CA
ZIP 95632
Phone: (209) 745-8080
Fax: (209) 745-8081

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 05D0964158
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-16-2026

About ADVENTIST HEALTH LODI MEMORIAL

This page provides the complete NPI Profile along with additional information for Adventist Health Lodi Memorial, a primary care provider established in Galt, California operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1164431383 assigned on August 2006. The practitioner's primary taxonomy code is 261QR1300X with license number 030000056 (CA). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Adventist Health Lodi Memorial. The authorized official of this NPI record is Jason Whitney (Finance Officer)

NPI
1164431383
Provider Legal Name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Other Organization Name
ADVENTIST HEALTH LODI MEMORIAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
387 CIVIC DR GALT, CA 95632
Location Phone
(209) 745-8080
Location Fax
(209) 745-8081
Mailing Address
PO BOX 884577 LOS ANGELES, CA 90088
Mailing Phone
(209) 334-3411
Mailing Fax
(209) 745-8081
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
08-05-2006
Last Update Date
04-01-2022
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A primary care provider (PCP) like Adventist Health Lodi Memorial sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities
License No.
030000056
License State
CA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JASON WHITNEY

Authorized Official Title
FINANCE OFFICER
Authorized Official Phone
(209) 339-7477

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
RHM18546FMEDICAID (05)CA 
ZZZ53360ZOTHER (01)CABLUE SHIELD PROV GRP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0964158
Facility Type
Physician Office
Certificate Effective Date
March 17, 2024
Certificate Expiration Date
March 16, 2026
Laboratory Director
JORGE OCEGUERA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Adventist Health Lodi Memorial to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1164431383
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21124832316
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 2 + 4 + 8 + 3 + 2 + 3 + 1 + 6 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1164431383 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659384212 JORGE OCEGUERA MD
Individual
Family Medicine387 CIVIC DR
GALT, CA 95632
(209) 745-8080
1669527594 MOHIUDDIN WASEEM M.D.
Individual
Internal Medicine387 CIVIC DR
GALT, CA 95632
(209) 745-8080
1225040439 JAMES MYERS PA-C
Individual
Physician Assistant387 CIVIC DR
GALT, CA 95632
(209) 745-8080
1447847801MISS VANESSA SOSA
Individual
Nurse Practitioner (Family)387 CIVIC DR
GALT, CA 95632
(209) 745-8080
1447652524 MOLLY CAMPBELL M.D.
Individual
Obstetrics & Gynecology387 CIVIC DR
GALT, CA 95632
(209) 745-8080

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164431383, enumerated in the NPI registry as an "organization" on August 05, 2006

The provider is located at 387 Civic Dr Galt, Ca 95632 and the phone number is (209) 745-8080

This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 05D0964158 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on August 05, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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