Blythe Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BLYTHE POST ACUTE LLC

Practice address

285 W Chanslor Way
Blythe, CA 92225-1246

Phone

(760) 922-8176

NPI assigned

Nov 4, 2014

Last updated

Dec 30, 2016By 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

Mr. David Johnson

Title

Ceo

Phone

(888) 309-0022

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194120030. Details of each certification follow.

• CCN 555383 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 555383

Legal name

BLYTHE POST ACUTE LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1989

Last certification

Feb 28, 2025

Beds

48

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Meridian

Organization structure

LLCProprietary

Incorporated

Oct 27, 2014 in CA

Enrollment address

285 W Chanslor Way
Blythe, CA 92225-1246

Nursing home name

BLYTHE POST ACUTE LLC

Affiliated entity

DAVID JOHNSON

Listed as

Blythe Post Acute LLCCCN 555383 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Aug 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4848.8 residents per day on average

Chain

David Johnson48 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

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.

• Leonel L Rodriguez, MD

  • Family Medicine Physician
  • Blythe, CA
  • NPI 1912098872

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 4

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

• Knolls West Post Acute LLC

  • Skilled Nursing Facility
  • Victorville, CA
  • NPI 1588091383

  Meridian Management Services LLC

  CMS ownership
• Spring Valley Post Acute LLC

  • Skilled Nursing Facility
  • Victorville, CA
  • NPI 1053748830

  Meridian Management Services LLC

  CMS ownership
• Las Vegas Post Acute & Rehabilitation LLC

  • Skilled Nursing Facility
  • Las Vegas, NV
  • NPI 1003150954

  Meridian Management Services LLC

  CMS ownership
• Torrey Pines Rehabilitation Hospital LLC

  • Skilled Nursing Facility
  • Las Vegas, NV
  • NPI 1558605402

  Meridian Management Services LLC

  CMS ownership

Affiliated clinicians 3

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

• Kenneth Grant Lucero, M.D.

  • Family Medicine Physician
  • Blythe, CA
  • NPI 1417079989

  Nursing home

  Care Compare affiliation
• Jimmy Tam Huy Tam Huy Pham, D.O.

  • Nephrology Physician
  • Apple Valley, CA
  • NPI 1982087391

  Nursing home

  Care Compare affiliation
• Leonel L Rodriguez, MD

  • Family Medicine Physician
  • Blythe, CA
  • NPI 1912098872

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1194120030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N PUENTE ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212804",
            "telephone_number": "888-309-0022",
            "fax_number": "714-256-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W CHANSLOR WAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251246",
            "telephone_number": "760-922-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLYTHE POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-309-0022",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC90055I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blythe Ambulance Service
• Blythe Eye Care Medical Group
• Blythe Healthcare Services, Inc.
• Blythe Internal Medicine Clinic Inc
• Blythe Oasis Community Inc
• BNCC, Inc. (Blythe Nursing Care Center)
• Cecil Bowen Jr., M.D.
• Carol Lavern Bradshaw, D.D.S.
• Brighter Path Recovery Center LLC
• David Brooks, MD

• Skilled Nursing Facility in Blythe, CA
• Providers in Blythe, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.