NPIMap

Organization Active NPI

Willow Creek Healthcare LLC

  • Home Health Agency
  • Central Point, OR
National Provider Identifier
1003639733
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
WILLOW CREEK HEALTHCARE LLC
Practice address
834 S Front St
Central Point, OR 97502-2726
Phone
(541) 664-7400
Fax
(866) 567-4380
NPI assigned
Nov 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

834 S Front St
Central Point, OR 97502-2726

Mailing address

834 S Front St
Central Point, OR 97502-2726
Phone (541) 664-7400

Other names 1

  • Signature Healthcare at Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250127000883 OR Part A Provider - Home Health Agency 3870022429 Practice locations: Central Point, OR

Home health agency certification: CCN 387142

Legal name
WILLOW CREEK HEALTHCARE LLC
Doing business as
SIGNATURE HEALTHCARE AT HOME
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 7, 1998
Last certification
May 24, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
834 S Front St
Central Point, OR 97502-2726
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Signature Healthcare at HomeCCN 387142
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Oct 7, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Signature Healthcare at Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2025 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector Jan 1, 2025
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
Frank Rogers Individual W-2 Managing EmployeeAd; Jan 1, 2025
John J Gochnour Individual Corporate OfficerPresident/LLC Manager Jan 1, 2025
Amber Tueller Individual Corporate OfficerSecretary Jan 1, 2025
Elliot McMillan Individual Corporate OfficerVice President Jan 1, 2025

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2025 Change of OwnershipThis provider was the buyer Signature Healthcare at HomeCCN 387142, OR, NPI 1780772996

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1003639733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 S FRONT ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022726",
            "telephone_number": "541-664-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 S FRONT ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022726",
            "telephone_number": "541-664-7400",
            "fax_number": "866-567-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Central Point, OR

Sources for this page

Verify at the official NPI Registry.