NPIMap

Organization Active NPI

Mission Health Services

Doing business as Mission at Castle Rock Rehabilitation Center

  • Skilled Nursing Facility
  • Green River, WY
National Provider Identifier
1104249432
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MISSION HEALTH SERVICES
Doing business as
Mission at Castle Rock Rehabilitation Center
Practice address
1445 Uinta Dr
Green River, WY 82935-5004
Phone
(801) 389-1523
NPI assigned
Jan 22, 2014
Last updated
Sep 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Authorized official

Name
Gary Kelso
Title
President
Phone
(801) 389-1523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1445 Uinta Dr
Green River, WY 82935-5004

Mailing address

2825 Virginia Way
Ogden, UT 84403-0452

Other names 1

  • Mission at Castle Rock Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140304000389 WY Part A Provider - Skilled Nursing Facility 7618915604 Practice locations: Green River, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104249432. Details of each certification follow.

Skilled nursing facility certification: CCN 535033

Legal name
MISSION HEALTH SERVICES
Doing business as
MISSION AT CASTLE ROCK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 3, 1989
Last certification
Apr 2, 2025
Beds
59
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Mission Health Services
Most recent change of ownership
May 1, 2014
Organization structure
CorporationNon-profit
Incorporated
Jan 3, 1990 in UT
Enrollment address
1445 Uinta Dr
Green River, WY 82935-5004
Nursing home name
MISSION AT CASTLE ROCK
Affiliated entity
MISSION HEALTH SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mission at Castle RockCCN 535033 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 3, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5951.1 residents per day on average
Chain
Mission Health Services7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Mission Health Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Gary M Kelso Individual Corporate DirectorBoard Member May 1, 2014
Ashley Ellis Individual Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Joseph Covey Individual Corporate DirectorBoard Member Dec 7, 2015
Kurt L Hunter Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
David Gessel Individual Corporate DirectorBoard Member Aug 25, 2008
Austin Keller Individual Corporate OfficerAdministrator Aug 21, 2024
Operational/Managerial Control Aug 21, 2024
Adp of the SNF Aug 21, 2024
Eddie Keele Individual Corporate OfficerCeo Apr 1, 2023
Operational/Managerial Control Apr 1, 2023
Dirk Anjewierden Individual Corporate DirectorBoard Member Jun 1, 2020
Michelle Zimbelman Individual Corporate OfficerCfo Mar 1, 2016
Operational/Managerial Control Mar 1, 2016
Adp of the SNF Mar 1, 2016
Mission Health Services Organization, Salt Lake City, UT Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest May 1, 2014 100%
Operational/Managerial Control May 1, 2024
Adp of the SNF May 1, 2024
Zachary Wootton Individual Corporate OfficerCoo Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mission at Community Living Rehabilitation CenterCenterfield, UT, CCN 465175 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF		 May 1, 2014
May 1, 2014
Mission at Alpine Rehabilitation CenterPleasant Grove, UT, CCN 465088 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF		 Apr 1, 2017
Jun 4, 2025
Mission at Nephi Nursing and RehabilitationNephi, UT, CCN 465107 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 11, 2025
Sep 3, 2025
Mission at Richfield Nursing and RehabilitationRichfield, UT, CCN 465059 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 11, 2025
Jun 11, 2025
Meadow Peak RehabilitationTaylorsville, UT, CCN 465192 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2024
Mar 14, 2025
True North Home HealthSouth Salt Lake, UT, CCN 467224 Home health agency 5% Or Greater Direct Ownership Interest (100%) May 16, 2024
True North HospiceSouth Salt Lake, UT, CCN 461599 Hospice 5% Or Greater Direct Ownership Interest (100%) May 16, 2024

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 2

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 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": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1104249432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 VIRGINIA WAY",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844030452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 UINTA DR",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829355004",
            "telephone_number": "801-389-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "KELSO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-389-1523"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission at Castle Rock Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green River, WY

Sources for this page

Verify at the official NPI Registry.