{"npi":"1972593788","type":"NPI-2","status":"active","name":{"display":"Adventist Health Clearlake Hospital Inc.","other":[],"organization_name":"ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.","authorised_official":"Parker Pridgen"},"specialty":{"primary_taxonomy":"261QR1300X","primary_taxonomy_description":"Rural Health Clinic/Center","slug":"rural-health-clinic-center","schema_org_specialty":null,"all":[{"code":"261QR1300X","description":"Rural Health Clinic/Center","primary":true,"state":"CA","license":"110000174"}]},"addresses":[{"purpose":"LOCATION","street_1":"21337 BUSH ST","city":"MIDDLETOWN","state":"CA","postal_code":"95461","country_code":"US","phone":"7079873311","fax":"7079872455"},{"purpose":"MAILING","street_1":"PO BOX 888837","city":"LOS ANGELES","state":"CA","postal_code":"900888837","country_code":"US"}],"license":{"state":"CA","number":"110000174"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"RHM08586F","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20021226000021","type_code":"00-17","type_desc":"PART A PROVIDER - RURAL HEALTH CLINIC","state":"CA","pac_id":"3072421197"}]},"enumeration_date":"2005-10-24","last_updated":"2025-09-15","_meta":{"source":"NPPES","snapshot_date":"2025-09-15","doc_url":"https://findmynpi.com/api"}}