NPIMap

Organization Active NPI

Sapphire at Tigard Rehab LLC

  • Skilled Nursing Facility
  • Portland, OR
National Provider Identifier
1124733944
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SAPPHIRE AT TIGARD REHAB LLC
Practice address
14145 SW 105TH Ave
Portland, OR 97224-4808
Phone
(503) 639-1144
NPI assigned
Jan 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Authorized official

Name
Kevin Michael Ricker
Title
Managing Member
Phone
(503) 887-7395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

14145 SW 105TH Ave
Portland, OR 97224-4808

Mailing address

305 NE 102ND Ave Ste 250
Portland, OR 97220-4170
Phone (503) 446-2877

Other identifiers 1

IdentifierTypeStateIssuer
500823245MedicaidOR

Other names 1

  • Tigard Rehabilitation and Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230811003097 OR Part A Provider - Skilled Nursing Facility 1153783865 Practice locations: Tigard, OR

Skilled nursing facility certification: CCN 385272

Legal name
SAPPHIRE AT TIGARD REHAB LLC
Doing business as
TIGARD REHABILITATION AND CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 2006
Last certification
Jan 17, 2025
Beds
112
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Sapphire Health Services
Organization structure
LLCProprietary
Incorporated
Dec 13, 2022 in OR
Enrollment address
14145 SW 105TH Ave
Tigard, OR 97224-4808
Nursing home name
TIGARD REHABILITATION AND CARE
Affiliated entity
SAPPHIRE HEALTH SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Tigard Rehabilitation and CareCCN 385272
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11265.8 residents per day on average
Chain
Sapphire Health Services8 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
3Fines totaling $69,509

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
38D0687051Sapphire at Tigard Rehab14145 SW 105TH Ave, Tigard, OR 97224Certificate of waiverDec 31, 2027

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
Sapphire Healthcare SRVS. Organization, Portland, OR Management services company Operational/Managerial Control Aug 1, 2023
Adp of the SNF May 23, 2025
Organization, Laguna Hills, CA LLC, Holding company, Real estate investment trust (REIT) Adp of the SNF Sep 1, 2014
Andrew L Becker Individual 5% Or Greater Direct Ownership InterestMember Dec 13, 2022 30%
Lisa J Hilty Individual 5% Or Greater Direct Ownership InterestMember Dec 13, 2022 25%
David P Larson Individual Operational/Managerial Control Sep 1, 2023
Adp of the SNF Aug 1, 2023
Kevin Ricker Individual 5% Or Greater Direct Ownership InterestMember Dec 13, 2022 40%
Bryan Morris Individual 5% Or Greater Direct Ownership InterestMember Dec 13, 2022 5%
Jeffrey Zheng Individual Operational/Managerial Control Sep 10, 2024
Adp of the SNF Sep 10, 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 7

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764288000000",
    "number": "1124733944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE 102ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204170",
            "telephone_number": "503-446-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14145 SW 105TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972244808",
            "telephone_number": "503-639-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAPPHIRE AT TIGARD REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-887-7395"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500823245",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tigard Rehabilitation and Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.