ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. – NPI #1124018031
General Acute Care Hospital

ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. is a general acute care hospital located in CLEARLAKE, CA. NPPES has assigned the NPI number 1124018031 to ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. on October 24, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 282NC0060X from the Health Care Provider Taxonomy code set, which is classified as General Acute Care Hospital, specializing in Critical Access

The NPI profile was last updated on Sep 15, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. below.

NPI Profile for
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.

NPI Number
1124018031
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
Primary location
15630 18TH AVE
CLEARLAKE, CA 95422-6710
Phone: (707) 994-6486 Fax: (707) 995-3631
Mailing address
PO BOX 888837
LOS ANGELES, CA 90088-8837
Phone: Fax:
Organization Subpart
No
Authorized Official
PARKER PRIDGEN
PRESIDENT
Phone: (707) 467-5200
Updated
Certification Date
Sep 15, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBLUE SHIELD INPATIENTCAZZZC1702Z
medicaidCAHSP40539G
medicaidCAZZR00539G
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
282NC0060X
- General Acute Care Hospital / Critical Access (Primary)
CA 110000174

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.2019.3
Content Type
Affiliation
Y
Endpoint Location
15630 18TH AVE,
CLEARLAKE, CA 77025-1669