Active NPI
Oregon Healthcare LLC
Doing business as Oregon Care Center
- Nursing Facility/Intermediate Care Facility
- Oregon, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- Legal business name
- OREGON HEALTHCARE LLC
- Doing business as
- Oregon Care Center
- Practice address
- 501 S Monroe St
Oregon, MO 64473-7800 - Phone
- (816) 564-6978
- NPI assigned
- Feb 20, 2023
- Last updated
- May 19, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Zucca
- Title
- Dosp
- Phone
- (816) 564-6978
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Primary | ||
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
501 S Monroe St
Oregon, MO 64473-7800
Mailing address
12401 E 43Rd St S Ste 201
Independence, MO 64055-5911
Phone (816) 564-6978
Other names 1
- Oregon Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230308000544 | MO | Part A Provider - Skilled Nursing Facility | 6103299409 | Practice locations: Oregon, MO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1043918998. Details of each certification follow.
Skilled nursing facility certification: CCN 265629
- Legal name
- OREGON HEALTHCARE LLC
- Doing business as
- OREGON HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1996
- Last certification
- Nov 21, 2024
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Tide Health Group
- Organization structure
- LLC
- Incorporated
- Jul 14, 2022 in MO
- Enrollment address
- 501 S Monroe St
Oregon, MO 64473-7800
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Oregon Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 1, 1996
- Medicare certification status
- Active
- Certified beds
- 60
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| David Yitzchok Kleiner | 5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 10.1% |
| Corporate Director | Dec 1, 2022 | ||
| Dkyh Missouri LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 10.1% |
| Sloans Lake Trust | 5% Or Greater Indirect Ownership Interest | Dec 1, 2022 | 63.33% |
| Blue Sky Basin LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 66.67% |
| Bernard David Perlow | 5% Or Greater Indirect Ownership Interest | Aug 31, 2021 | 25% |
| Corporate Director | Aug 31, 2021 | ||
| Eliot Berger | Corporate Director | Dec 1, 2022 | 100% |
| Operational/Managerial Control | Dec 1, 2022 | ||
| Gateway Mo2 LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 100% |
| DKDP Missouri LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 23.23% |
Facilities with the same owner 7
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Buffalo Prairie Center for Rehab and Healthcare
- Skilled Nursing Facility
- Buffalo, MO
- NPI 1013679596
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust
-
dba Country Aire Retirement Center
- Skilled Nursing Facility
- Lewistown, MO
- NPI 1619639192
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust
-
dba Georgian Gardens Center for Rehab and Healthcare
- Skilled Nursing Facility
- Potosi, MO
- NPI 1972265452
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust
-
dba Golden Years Center for Rehab and Healthcare
- Skilled Nursing Facility
- Harrisonville, MO
- NPI 1063174548
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust
-
dba Abode Health and Wellness Center
- Skilled Nursing Facility
- Independence, MO
- NPI 1790658086
Blue Sky Basin LLC
-
dba Nodaway Nursing Home
- Nursing Facility/Intermediate Care Facility
- Maryville, MO
- NPI 1497453344
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Gateway Mo2 LLC, Sloans Lake Trust
-
dba Pleasant View
- Nursing Facility/Intermediate Care Facility
- Rock Port, MO
- NPI 1699473546
Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Gateway Mo2 LLC, Sloans Lake Trust
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Fairfax, MO
- NPI 1578557872
-
- Family Medicine Physician
- Maryville, MO
- NPI 1922035070
-
- Family Medicine Physician
- Junction City, KS
- NPI 1427230069
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684454400000",
"number": "1043918998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12401 E 43RD ST S STE 201",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640555911",
"telephone_number": "816-564-6978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S MONROE ST",
"city": "OREGON",
"state": "MO",
"postal_code": "644737800",
"telephone_number": "816-564-6978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OREGON HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-02-20",
"last_updated": "2023-05-19",
"certification_date": "2023-05-19",
"status": "A",
"authorized_official_last_name": "ZUCCA",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "DOSP",
"authorized_official_telephone_number": "816-564-6978"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Oregon Care Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Oregon Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oregon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.