NPIMap

Organization Active NPI

Medford Operations, LLC

  • Skilled Nursing Facility
  • Medford, OR
National Provider Identifier
1093059644
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MEDFORD OPERATIONS, LLC
Practice address
625 Stevens St
Medford, OR 97504-6719
Phone
(541) 779-3551
Fax
(541) 779-3658
NPI assigned
Nov 20, 2012
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Mary E. Kofstad
Title
Ceo
Phone
(971) 224-2033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

625 Stevens St
Medford, OR 97504-6719

Mailing address

25117 SW Parkway Ave
Suite F
Wilsonville, OR 97070-9697
Phone (503) 570-3405

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130222000137 OR Part A Provider - Skilled Nursing Facility 5395990469 Practice locations: Medford, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093059644. Details of each certification follow.

Skilled nursing facility certification: CCN 385024

Legal name
MEDFORD OPERATIONS, LLC
Doing business as
AVAMERE HEALTH SERVICES OF ROGUE VALLEY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Apr 19, 2024
Beds
91
Ownership / control type
Corporation
Multi-facility organization
Avamere
Organization structure
LLCProprietary
Incorporated
Nov 7, 2012 in OR
Enrollment address
625 Stevens St
Medford, OR 97504-6719
Nursing home name
AVAMERE HEALTH SERVICES OF ROGUE VALLEY
Affiliated entity
AVAMERE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avamere Health Services of Rogue ValleyCCN 385024 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9165.8 residents per day on average
Chain
Avamere27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0656896Avamere Health Services of Rogue Valley625 Stevens Street, Medford, OR 97504Certificate of waiverDec 17, 2026

National Provider Directory

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
Karl Rickard Miller Individual 5% Or Greater Indirect Ownership Interest Nov 7, 2012 100%
Ari Operations, LLC Organization, Wilsonville, OR LLC 5% Or Greater Indirect Ownership Interest Nov 7, 2012 100%
Andrew Simpson Individual Corporate OfficerCfo Jun 1, 2024
Ariso LLC Organization, Wilsonville, OR LLC 5% Or Greater Direct Ownership Interest Nov 7, 2012 100%
Chase Judd Individual W-2 Managing EmployeeAd; Jan 3, 2022
Karen T Kahn Individual Contracted Managing EmployeeMD; Oct 1, 2008
Avamere Group LLC Organization, Wilsonville, OR LLC 5% Or Greater Indirect Ownership Interest Nov 7, 2012 100%
Mary Kofstad Individual Corporate OfficerCoo Feb 13, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1093059644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "503-570-3405",
            "fax_number": "503-570-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 STEVENS ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046719",
            "telephone_number": "541-779-3551",
            "fax_number": "541-779-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "KOFSTAD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "971-224-2033"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.