LODI MEMORIAL COMMUNITY CLINIC - VINE
NPI 1225285695
Clinic/Center - Primary Care in Lodi, CA

Active since August 27, 2008
1235 W VINE ST, SUITE 22, LODI, CA 95240(209) 334-8520(209) 339-7659 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lodi Memorial Community Clinic - Vine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LODI MEMORIAL COMMUNITY CLINIC - VINE (NPI 1225285695) is a healthcare organization registered as a primary care in Lodi, California and active in the NPI registry since August 2008. The organization lists Jason Whitney, Finance Officer, as its authorized official.

NPPES Registry Identity

NPI1225285695
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameLODI MEMORIAL HOSPITAL ASSOCIATION, INC
Location Address1235 W VINE ST, SUITE 22Lodi, CA 95240-5109
Mailing AddressPo Box 884577Los Angeles, CA 90088-4577 · (209) 334-3411 · Fax (209) 339-7659
Fax(209) 339-7659
Organization SubpartYes
Authorized OfficialJason WhitneyFinance Officer · (209) 339-7477
Enumeration DateAugust 27, 2008
Last NPPES UpdateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
✔ NPI 1225285695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in CA · 550001051
1235 W VINE ST, Lodi, CA 95240

Other Names 1

Doing Business AsLodi Memorial Community Clinic - Vine

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lodi Memorial Community Clinic - Vine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20050517000577Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

220

Medicare enrollment records show 220 clinicians reassign Medicare billing to Lodi Memorial Community Clinic - Vine, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 53 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 25

Diagnostic Radiology76
Internal Medicine48
Nurse Practitioner14
Family Practice13
Physical Medicine and Rehabilitation10
Hospitalist9
Interventional Radiology9
Cardiovascular Disease (Cardiology)7
17 other specialties34

Nearest to this location (20)

See all 220
Nurse Practitioner
NPI 1437161643
1235 W VINE ST # 20
Lodi, CA 95240
(209) 339-7600
✔ PECOS✔ Accepts MedicareSame address
Hospitalist
NPI 1679542120
845 S FAIRMONT AVE SUITE 8
Lodi, CA 95240
(209) 339-7625
✔ PECOS✔ Accepts MedicareSame address
Endocrinology
NPI 1013023274
1235 W VINE ST SUITE 22
Lodi, CA 95240
(209) 334-8520
✔ PECOS✔ Accepts MedicareSame address
Pulmonary Disease
NPI 1821000480
845 S FAIRMONT AVE STE 8
Lodi, CA 95240
(209) 339-7410
✔ PECOS✔ Accepts MedicareSame address
Diagnostic Radiology
NPI 1629173935
1121 W VINE ST SUITE 15
Lodi, CA 95240
(209) 334-4416
✔ PECOS✔ Accepts Medicare0.1 mi
Diagnostic Radiology
NPI 1154330389
1121 W VINE ST SUITE 15
Lodi, CA 95240
(209) 334-4416
✔ PECOS✔ Accepts Medicare0.1 mi
Internal Medicine
NPI 1346681293
975 S FAIRMONT AVE
Lodi, CA 95240
(209) 339-7639
✔ PECOS0.1 mi
Internal Medicine
NPI 1750498309
975 S FAIRMONT AVE
Lodi, CA 95240
(209) 334-3411
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1831468255
975 S. FAIRMONT AVENUE
Lodi, CA 95240
(209) 333-5124
✔ PECOS0.1 mi
Nurse Practitioner
NPI 1982037040
975 S FAIRMONT AVE
Lodi, CA 95240
(209) 334-3411
✔ PECOS✔ Accepts Medicare0.1 mi
Anesthesiology
NPI 1760450092
975 S FAIRMONT AVE
Lodi, CA 95240
(602) 540-3744
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1609147354
999 S FAIRMONT AVE STE 235
Lodi, CA 95240
(209) 334-0799
✔ PECOS0.2 mi
Cardiovascular Disease (Cardiology)
NPI 1063690717
999 S FAIRMONT AVE STE 130
Lodi, CA 95240
(209) 366-2001
✔ PECOS✔ Accepts Medicare0.2 mi
Orthopedic Surgery
NPI 1326482142
999 S FAIRMONT AVE STE 125
Lodi, CA 95240
(209) 334-8514
✔ PECOS✔ Accepts Medicare0.2 mi
Gastroenterology
NPI 1902172406
999 S FAIRMONT AVE STE 125
Lodi, CA 95240
(209) 334-8514
✔ PECOS✔ Accepts Medicare0.2 mi
Family Practice
NPI 1558455618
999 S FAIRMONT AVE SUITE 135
Lodi, CA 95240
(209) 366-2060
✔ PECOS✔ Accepts Medicare0.2 mi
Physical Medicine and Rehabilitation
NPI 1174886881
975 S FAIRMONT AVE
Lodi, CA 95240
(209) 334-3411
✔ PECOS✔ Accepts Medicare0.2 mi
Physical Medicine and Rehabilitation
NPI 1770076994
515 S FAIRMONT AVE
Lodi, CA 95240
(209) 334-8570
✔ PECOS✔ Accepts Medicare0.4 mi
Obstetrics/Gynecology
NPI 1831345644
2415 W VINE ST STE 103
Lodi, CA 95242
(209) 333-3117
✔ PECOS✔ Accepts Medicare1.0 mi
Emergency Medicine
NPI 1578506952
2415 W VINE ST SUITE 105
Lodi, CA 95242
(209) 339-7435
✔ PECOS✔ Accepts Medicare1.0 mi
See all 220 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lodi Memorial Hospital Association, Inc's NPI number?

The NPI number for Lodi Memorial Hospital Association, Inc is 1225285695. It was assigned to this organization in the NPPES registry on August 27, 2008. The provider is doing business as Lodi Memorial Community Clinic - Vine.

Where is Lodi Memorial Hospital Association, Inc located?

Lodi Memorial Hospital Association, Inc is located at 1235 W Vine St Suite 22, Lodi, CA 95240. The listed phone number is (209) 334-8520.

What is Lodi Memorial Hospital Association, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Lodi Memorial Hospital Association, Inc enrolled in Medicare?

Yes. Lodi Memorial Hospital Association, Inc is registered in the Medicare PECOS enrollment system.

When is Lodi Memorial Hospital Association, Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Lodi Memorial Hospital Association, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 220 clinicians in 25 Medicare specialties reassign their Medicare billing to Lodi Memorial Hospital Association, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (76), Internal Medicine (48) and Nurse Practitioner (14). Of these, 4 practice at this address and 53 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lodi Memorial Hospital Association, Inc was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.