McKenna Healthcare of Portsmouth, Inc.
Organization Active NPI Skilled Nursing Facility · Portsmouth, OH
NPI 1215344288 · NPPES record last updated Nov 3, 2015
Key facts
- NPI
- 1215344288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- MCKENNA HEALTHCARE OF PORTSMOUTH, INC.
- Practice address
- 1319 Spring St
Portsmouth, OH 45662-3715 - Phone
- (740) 354-6619
- Fax
- (740) 354-5710
- NPI assigned
- Jul 22, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Paul B. Bergsten, LNHA
- Title
- Ceo
- Phone
- (937) 825-6622
Corporate family (same tax ID) 1
Facilities with the same owner 9
Practitioners 1
-
Sean D Stiltner, DO
Medicare Care Compare: Nursing home
- Listed as
- River Run Healthcare of Portsmouth
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 1, 1992
- Medicare certification status
- Active
- Certified beds
- 25 · 22.2 residents per day on average
- Chain
- Hillstone Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 365867
- Legal name
- MCKENNA HEALTH CARE OF PORTSMOUTH INC
- Doing business as
- RIVER RUN HEALTHCARE OF PORTSMOUTH
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 1, 1992
- Last certification
- Feb 20, 2025
- Beds
- 25
- Ownership / control type
- Corporation
- Multi-facility organization
- Hillstone Healthcare
- Most recent change of ownership
- Sep 1, 2014
- Organization structure
- Corporation · Proprietary
- Incorporated
- Jul 7, 2014 in OH
- Enrollment address
- 1319 Spring St
Portsmouth, OH 45662-2675 - Nursing home name
- RIVER RUN HEALTHCARE OF PORTSMOUTH
- Affiliated entity
- HILLSTONE HEALTHCARE
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Whitney Berryman |
W-2 Managing Employee |
Dec 14, 2020 | |
| Paul B Bergsten |
5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | 60% |
| Corporate Officer |
Sep 1, 2017 | ||
| Corporate Director |
Sep 1, 2017 | ||
| Anthony Wheaton |
Operational/Managerial Control | Sep 1, 2014 | |
| Matthew Dapore |
5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | 40% |
| Corporate Officer |
Sep 1, 2017 | ||
| Corporate Director |
Sep 1, 2017 | ||
| Hillstone Healthcare Inc. |
5% Or Greater Direct Ownership Interest | Sep 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141113002004 | OH | Part a Provider - Skilled Nursing Facility | 8628290251 | Practice locations: Portsmouth, OH |
National Provider Directory
- Tax ID family
- Crystal Care Center of Portsmouth
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1319 Spring St
Portsmouth, OH 45662-3715
Mailing address
1319 Spring St
Portsmouth, OH 45662-3715
Phone (740) 354-6619
Other names
- Crystal Care Center of Portsmouth
Other providers in Portsmouth, OH
- Jenna Jo McGuire
- Rachel McGuire
- Deanna McHenry
- Joshua McIntire
- Amy Lynn McIntyre
- McKenna Healthcare, LLC
- Stephanie McKenzie
- Tonya Rebecca McKenzie
- Carolyn Dale McKinnon
- Mallory McKnight
All providers in Portsmouth, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.