NPIMap

Organization Active NPI

Baseline Healthcare Inc.

  • Skilled Nursing Facility
  • Boulder, CO
National Provider Identifier
1194311571
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BASELINE HEALTHCARE INC.
Practice address
4685 Baseline Rd
Boulder, CO 80303-2601
Phone
(303) 494-0535
NPI assigned
Dec 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4685 Baseline Rd
Boulder, CO 80303-2601

Mailing address

4685 Baseline Rd
Boulder, CO 80303-2601
Phone (303) 494-0535

Other names 1

  • Boulder Canyon Health and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210325002379 CO Part A Provider - Skilled Nursing Facility 8729495379 Practice locations: Boulder, CO

Skilled nursing facility certification: CCN 065222

Legal name
BASELINE HEALTHCARE INC.
Doing business as
BOULDER CANYON HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1985
Last certification
Feb 6, 2024
Beds
140
Ownership / control type
Corporation
Multi-facility organization
Endura Healthcare
Organization structure
CorporationProprietary
Incorporated
Dec 15, 2020 in NV
Enrollment address
4685 Baseline Rd
Boulder, CO 80303-2601
Nursing home name
BOULDER CANYON HEALTH AND REHABILITATION
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Boulder Canyon Health and RehabilitationCCN 065222
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140121.1 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Baseline Healthcare Inc3 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.

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
SMV Boulder Organization, New York, NY LLC Adp of the SNF Apr 1, 2021
Ray Lauritzen Individual Operational/Managerial ControlAdministrator Apr 1, 2021
Managing Control - Governing BodyAdministrator Apr 1, 2021
Adp of the SNF Jun 20, 2025
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 19, 2014 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Dec 15, 2020
Ami Sato Individual Corporate OfficerTreasurer Baseline Healthcare, Inc. Sep 9, 2024
Endura Healthcare LLC Organization, San Juan Capistrano, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 15, 2020 100%
David Jorgensen Individual Corporate DirectorDirector Baseline Healthcare, Inc. Dec 15, 2020
Christopher S Horton Individual Operational/Managerial Control Feb 1, 2023
Managing Control - Governing BodyMedical Director Feb 1, 2023
Adp of the SNF Jun 20, 2025
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
David Dunyon Individual Corporate OfficerPresident Baseline Healthcare, Inc. Sep 9, 2024
Soon Burnam Individual Corporate OfficerSecretary Dec 15, 2020

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 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1194311571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 BASELINE RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032601",
            "telephone_number": "303-494-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 BASELINE RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032601",
            "telephone_number": "303-494-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASELINE HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Boulder Canyon Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.