Organization Active NPI

Keizer Campus Operations, LLC

Doing business as Avamere Court at Keizer

  • Skilled Nursing Facility
  • Keizer, OR
National Provider Identifier
1093732901
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KEIZER CAMPUS OPERATIONS, LLC
Doing business as
Avamere Court at Keizer
Practice address
5210 River Rd N
Keizer, OR 97303-4568
Phone
(503) 393-3624
NPI assigned
Jul 16, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
K. Rickard Miller Jr.
Title
Manager
Phone
(503) 570-3405

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5210 River Rd N
Keizer, OR 97303-4568

Mailing address

25117 SW Parkway Ave
Suite F
Wilsonville, OR 97070-9697

Other names 1

  • Avamere Court at Keizer Doing business as

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
O20100709000164 OR Part A Provider - Skilled Nursing Facility 8729030093 Practice locations: Keizer, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093732901. Details of each certification follow.

Skilled nursing facility certification: CCN 385233

Legal name
KEIZER CAMPUS OPERATIONS, LLC
Doing business as
AVAMERE COURT AT KEIZER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1993
Last certification
May 31, 2024
Beds
69
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Avamere Living
Organization structure
LLCProprietary
Enrollment address
5210 River Rd N
Keizer, OR 97303-4568
Nursing home name
AVAMERE COURT AT KEIZER
Affiliated entity
AVAMERE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avamere Court at KeizerCCN 385233 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6952.0 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
38D0674394Avamere Court at Keizer5210 River Rd N, Keizer, OR 97303Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 47

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

NameRoleSinceShare
Avamere Skilled Advisors LLC Organization, Wilsonville, OR LLC, For-profit Operational/Managerial Control Mar 16, 2005
Adp of the SNF Jul 11, 2025
Sabra Health Care Reit Inc Organization, Tustin, CA Corporation, Holding company, For-profit, Real estate investment trust (REIT) Adp of the SNF Aug 17, 2017
Michelle Funderberg Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Dec 31, 2024
Karl Rickard Miller Individual 5% Or Greater Indirect Ownership Interest Mar 16, 2005 100%
Organization, Seattle, WA For-profit Adp of the SNF Jul 11, 2025
Ari Operations, LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 6, 2006 100%
Organization, Tustin, CA LLC, Holding company, For-profit Adp of the SNF Aug 7, 2015
Jennifer Dana Individual Operational/Managerial Control May 1, 2022
Adp of the SNF May 1, 2022
Andrew Simpson Individual Operational/Managerial Control Jun 1, 2024
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jun 1, 2024
Midcap Finco LLC Organization, Bethesda, MD LLC, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Jan 22, 2010 100%
Operational/Managerial Control Jan 22, 2010
Glen Robert Cavallo Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Carolyn Staples Individual Adp of the SNF Oct 5, 2023
Karl Rickard Miller Jr Revocable Trust Organization, Ketchum, ID 5% Or Greater Indirect Ownership Interest Jul 11, 2011 100%
Fusion Medical Staffing LLC Organization, Elkhorn, NE LLC, Medical staffing company, For-profit Adp of the SNF Apr 12, 2024
Avamere Health Services LLC Organization, Wilsonville, OR LLC, For-profit, Chain home office Operational/Managerial Control Mar 16, 2005
Adp of the SNF Jul 11, 2025
Ike Okoli Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Todd Inskeep Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Jan 21, 2022
Consolidated Billing Services Inc Organization, Spokane Valley, WA Corporation, For-profit Adp of the SNF Mar 16, 2005
Veronica Davis Individual Adp of the SNF May 6, 2024
Colby Strunk Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Sep 6, 2022
Justin Polson Individual Managing Control - Governing Body Jun 1, 2025
Adp of the SNF Feb 10, 2025
Kevala Technologies, Inc Organization, Kirkland, WA Corporation, Medical staffing company, For-profit Adp of the SNF Oct 31, 2023
Shannon Becerra Individual Adp of the SNF Feb 1, 2025
Kim Games Individual Adp of the SNF Aug 15, 2024
Rande Holdings, LLC Organization, Wilsonville, OR LLC, For-profit Adp of the SNF Jun 1, 2024
Michele Powelson Individual Operational/Managerial Control Mar 25, 2015
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Mar 25, 2015
Rebecca Sawyer Individual Operational/Managerial Control May 8, 2023
Adp of the SNF May 8, 2023
Tonia Hoskins Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Mary Kofstad Individual Operational/Managerial Control Feb 13, 2024
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Feb 13, 2021
Sabra Health Care Limited Partnership Organization, Tustin, CA Holding company, For-profit Adp of the SNF Aug 17, 2017
Yolanda Presley Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Jolynn Munro Individual Operational/Managerial Control Sep 1, 2023
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Sep 1, 2023
Nathan M Ruden Individual Operational/Managerial Control Jun 1, 2023
Adp of the SNF Jun 1, 2023
Rebecca Xiong Individual Operational/Managerial Control Dec 1, 2023
Adp of the SNF Dec 1, 2023
Incovate Solutions, LLC Organization, Charlotte, NC LLC, For-profit Adp of the SNF Jan 21, 2022
Ari CBC LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 6, 2006 100%
Organization, Tacoma, WA LLC, Medical staffing company, For-profit Adp of the SNF Jul 11, 2025
Avamere Group LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 6, 2006 100%
Cody Feakin Individual Operational/Managerial Control Jul 15, 2025
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 1, 2025
Misty Dawn Reid Individual Operational/Managerial Control Jan 2, 2025
Adp of the SNF Jan 2, 2025
Tracy Gasperini Individual Operational/Managerial Control Apr 16, 2019
Adp of the SNF Apr 16, 2019
Amanda Sanders Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Kevin Hill Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Mar 12, 2022
Andrea Doepker Individual Operational/Managerial Control Sep 28, 2023
Adp of the SNF Sep 28, 2023
Sabra Health Care, LLC Organization, Tustin, CA LLC, Holding company, For-profit Adp of the SNF Aug 17, 2017
Damien Haskins Individual Managing Control - Governing BodyVoting Member Sep 1, 2025
Carrie Vanderzanden Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 1, 2025

Owners & managing parties with NPI records 2

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

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

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": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1093732901",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034568",
            "telephone_number": "503-393-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEIZER CAMPUS OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "K. RICKARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-570-3405",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": [
        {
            "organization_name": "Avamere Court at Keizer",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avamere Court at Keizer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keizer, OR

Sources for this page

Verify at the official NPI Registry.