Ravenscroft Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RAVENSCROFT HEALTHCARE LLC

Doing business as

St. Joseph's Rehabilitation and Care Center

Practice address

401 N 18TH St
Norfolk, NE 68701-3651

Phone

(402) 644-7375

NPI assigned

Aug 9, 2024

Last updated

Sep 30, 2024By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• St. Joseph's Rehabilitation and Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164253373. Details of each certification follow.

• CCN 285160 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 285160

Legal name

RAVENSCROFT HEALTHCARE LLC

Doing business as

ST JOSEPHS REHABILITATION AND CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1995

Last certification

Dec 17, 2024

Beds

83

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Ravenscroft Healthcare LLC

Organization structure

LLCProprietary

Enrollment address

401 N 18TH St
Norfolk, NE 68701-3651

Nursing home name

ST. JOSEPH'S REHABILITATION AND CARE CENTER

Affiliated entity

THE ENSIGN GROUP

Listed as

St. Joseph's Rehabilitation and Care CenterCCN 285160 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8363.0 residents per day on average

Chain

The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Ravenscroft 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.

• Ravenscroft Healthcare LLC

  dba Skyview Villa Assisted Living

  • Assisted Living Facility
  • Norfolk, NE
  • NPI 1649001827
  NPD tax ID

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.

Owners & managing parties with NPI records 1

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

• Samuel J. Recob, M.D.

  • Family Medicine Physician
  • Laurel, NE
  • NPI 1427218577

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 3

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.

• Charles Harper Jr., MD

  • Internal Medicine Physician
  • Norfolk, NE
  • NPI 1063620961
  NPD (past)
• Bryon D Hirschman, MD

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1194739912
  NPD (past)
• Chandra Kumar Ponniah, MBBS

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1881858405
  NPD (past)

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Joseph Paul Dangberg, M.D.

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1093032377

  Nursing home

  Care Compare affiliation
• Kari L Galyen, MD

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1134112832

  Nursing home

  Care Compare affiliation
• Charles Harper Jr., MD

  • Internal Medicine Physician
  • Norfolk, NE
  • NPI 1063620961

  Nursing home

  Care Compare affiliation
• Bryon D Hirschman, MD

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1194739912

  Nursing home

  Care Compare affiliation
• Chandra Kumar Ponniah, MBBS

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1881858405

  Nursing home

  Care Compare affiliation
• Alan J Spanel, MD

  • Internal Medicine Physician
  • Norfolk, NE
  • NPI 1023508892

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1164253373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 18TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 18TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013651",
            "telephone_number": "402-644-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSCROFT HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph's Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rajiv Ranjan, M.D.
• Amanda Rasmussen
• Kathlene Rebecca Rasmussen, APRN-NP-C
• Rachel Rasmussen
• Tamara Rasmussen
• Ravenscroft Healthcare LLC (Skyview Villa Assisted Living)
• Sushil Rayamajhi, M.B.B.S.
• Cassandra Rayback
• Ingrid Raymundo
• Alex Razee

• Skilled Nursing Facility in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.