Sapphire at Myrtle Creek LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAPPHIRE AT MYRTLE CREEK LLC

Doing business as

Myrtle Creek Rehabilitation and Care

Practice address

637 Ash St
Myrtle Point, OR 97458-1133

Phone

(503) 887-7395

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Kevin Michael Ricker

Title

Managing Member

Phone

(503) 887-7395

Specialties & licenses 1

Addresses

Other names 1

• Myrtle Creek Rehabilitation and Care Doing business as

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1043925852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE 102ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204170",
            "telephone_number": "503-446-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 ASH ST",
            "city": "MYRTLE POINT",
            "state": "OR",
            "postal_code": "974581133",
            "telephone_number": "503-887-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAPPHIRE AT MYRTLE CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-887-7395"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle Creek Rehabilitation and Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• New Creations LLC 1111
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• Skilled Nursing Facility in Myrtle Point, OR
• Providers in Myrtle Point, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.