Active NPI
Sharon Care Center, Inc
- Skilled Nursing Facility
- Centralia, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1304
- Legal business name
- SHARON CARE CENTER, INC
- Practice address
- 1509 Harrison Ave
Centralia, WA 98531-4568 - Phone
- (360) 736-0112
- Fax
- (360) 807-0667
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Doug Devore
- Title
- Cfo
- Phone
- (425) 392-4066
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1304 | WA | Primary |
Addresses
Primary practice location
1509 Harrison Ave
Centralia, WA 98531-4568
Mailing address
1509 Harrison Ave
Centralia, WA 98531-4568
Phone (360) 736-0112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4113049 | Medicaid | WA |
Other names 1
- Sharon Care Center
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120507000561 | WA | Part A Provider - Skilled Nursing Facility | 1951563014 | Practice locations: Centralia, WA |
Skilled nursing facility certification: CCN 505429
- Legal name
- SHARON CARE CENTER INC
- Doing business as
- SHARON CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jan 1, 1992
- Last certification
- Sep 13, 2024
- Beds
- 42
- Ownership / control type
- Partnership
- Organization structure
- Corporation
- Enrollment address
- 1509 Harrison Ave
Centralia, WA 98531-4568 - Nursing home name
- SHARON CARE CENTER
- Affiliated entity
- REGENCY PACIFIC MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sharon Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Jan 1, 1992
- Medicare certification status
- Active
- Certified beds
- 42
- Chain
- Regency Pacific Management
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0637082 | Sharon Care Center | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Wolkin | 5% Or Greater Direct Ownership Interest | May 1, 2015 | 10% |
| General Partnership Interest | May 1, 2015 | 10% | |
| Adp of the SNF | Jan 1, 2023 | ||
| Pharmacy Corporation of America | Adp of the SNF | Jan 1, 2023 | |
| Premere Rehab LLC | Adp of the SNF | Jan 1, 2024 | |
| Nightingale Healthcare LLC. | Operational/Managerial Control | Jan 1, 2023 | |
| Floyd Sekeramayi | Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Jonathan Blood | Operational/Managerial Control | May 2, 2024 | |
| Adp of the SNF | May 2, 2024 | ||
| James Lee Clay | 5% Or Greater Direct Ownership Interest | Apr 20, 2000 | 90% |
| General Partnership Interest | Apr 20, 2000 | 90% | |
| Sergio Martinez | Operational/Managerial Control | Jan 9, 2023 | |
| Adp of the SNF | Jan 9, 2023 |
Owners & managing parties with NPI records 5
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Tacoma, WA
- NPI 1912324559
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Bellingham, WA
- NPI 1528000387
Nightingale Healthcare LLC.
-
- Skilled Nursing Facility
- Everett, WA
- NPI 1477087443
Nightingale Healthcare LLC.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Centralia, WA
- NPI 1649267196
-
- Internal Medicine Physician
- Tacoma, WA
- NPI 1912324559
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": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773273600000",
"number": "1194763565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 HARRISON AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314568",
"telephone_number": "360-736-0112",
"fax_number": "360-807-0667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 HARRISON AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314568",
"telephone_number": "360-736-0112",
"fax_number": "360-807-0667"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHARON CARE CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A",
"authorized_official_last_name": "DEVORE",
"authorized_official_first_name": "DOUG",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "425-392-4066"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WA",
"license": "1304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4113049",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd",
"address_2": "SteB",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Sharon Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.