NPIMap

Organization Active NPI

Bear River Healthcare LLC

Doing business as Symbii Home Health

  • Home Health Agency
  • Brigham City, UT
National Provider Identifier
1124643499
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BEAR RIVER HEALTHCARE LLC
Doing business as
Symbii Home Health
Practice address
646 S Main St Ste 105
Brigham City, UT 84302-3273
Phone
(435) 752-2291
NPI assigned
Jun 12, 2020
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

646 S Main St Ste 105
Brigham City, UT 84302-3273

Mailing address

646 S Main St Ste 105
Brigham City, UT 84302-3273
Phone (435) 752-2291

Other names 1

  • Symbii Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200806001512 UT Part A Provider - Home Health Agency 9830514983 Practice locations: Brigham City, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124643499. Details of each certification follow.

Home health agency certification: CCN 467219

Legal name
BEAR RIVER HEALTHCARE LLC
Doing business as
SYMBII HOME HEALTH BEAR RIVER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 9, 2005
Last certification
Jan 14, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 11, 2020 in NV
Enrollment address
646 S Main St
Ste 105
Brigham City, UT 84302-3273
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Symbii Home Health Bear RiverCCN 467219 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jun 9, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Bear River Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Networks

  • UT PPO D-SNPPlans: DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004-000, H4473)

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
Jeremy R Deatry Individual W-2 Managing EmployeeAd; Aug 19, 2025
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2020 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate Director Aug 1, 2022
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2020 100%
John J Gochnour Individual Corporate OfficerPresident Mar 26, 2026
Amber Tueller Individual Corporate OfficerSecretary Apr 10, 2024
Elliot McMillan Individual Corporate OfficerVice President Jul 1, 2020

Facilities with the same owner 141

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

View all 141

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2020 Change of OwnershipThis provider was the buyer Signature Healthcare at Home- Nut HHCCN 467219, UT, NPI 1902298185

Practitioners & affiliated clinicians

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": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1124643499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S MAIN ST STE 105",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023273",
            "telephone_number": "435-752-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S MAIN ST STE 105",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023273",
            "telephone_number": "435-752-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR RIVER HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Symbii Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brigham City, UT

Sources for this page

Verify at the official NPI Registry.