NPIMap

Organization Active NPI

Prairie Waters Healthcare, Inc.

Doing business as The Springs at St. Andrews Village

  • Skilled Nursing Facility
  • Aurora, CO
National Provider Identifier
1093574964
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRAIRIE WATERS HEALTHCARE, INC.
Doing business as
The Springs at St. Andrews Village
Practice address
2670 S Abilene St
Aurora, CO 80014-2336
Phone
(303) 695-9300
NPI assigned
Mar 14, 2024
Last updated
Aug 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2670 S Abilene St
Aurora, CO 80014-2336

Mailing address

2670 S Abilene St
Aurora, CO 80014-2336

Other names 1

  • The Springs at St. Andrews Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240702003362 CO Part A Provider - Skilled Nursing Facility 3577007459 Practice locations: Aurora, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093574964. Details of each certification follow.

Skilled nursing facility certification: CCN 065388

Legal name
PRAIRIE WATERS HEALTHCARE, INC.
Doing business as
THE SPRINGS AT ST. ANDREWS VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Mar 5, 2007
Last certification
Mar 27, 2024
Beds
58
Ownership / control type
Corporation
Multi-facility organization
Endura Healthcare Incorporated
Organization structure
CorporationProprietary
Incorporated
Feb 5, 2024 in NV
Enrollment address
2670 S Abilene St
Aurora, CO 80014-2336
Nursing home name
THE SPRINGS AT ST. ANDREWS VILLAGE
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Springs at St. Andrews VillageCCN 065388 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Corporation
Certified
Mar 5, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5854.3 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $14,220

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2024 100%
Endura Healthcare LLC Organization, San Juan Capistrano, CA LLC 5% Or Greater Direct Ownership Interest Feb 5, 2024 100%
David Jorgensen Individual Corporate DirectorDirector Feb 5, 2024
Craig Fitch Individual Corporate OfficerSecretary Feb 5, 2024
David Dunyon Individual Corporate OfficerPresident Feb 5, 2024
Operational/Managerial ControlPresident Jun 1, 2024 100%
Soon Burnam Individual Corporate OfficerTreasurer Feb 5, 2024

Facilities with the same owner 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 5

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": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1093574964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 S ABILENE ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 S ABILENE ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142336",
            "telephone_number": "303-695-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE WATERS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Springs at St. Andrews Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.