NPIMap

Organization Active NPI

McKenna Healthcare of Portsmouth, Inc.

Doing business as Crystal Care Center of Portsmouth

  • Skilled Nursing Facility
  • Portsmouth, OH
National Provider Identifier
1215344288
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MCKENNA HEALTHCARE OF PORTSMOUTH, INC.
Doing business as
Crystal Care Center of Portsmouth
Practice address
1319 Spring St
Portsmouth, OH 45662-3715
Phone
(740) 354-6619
Fax
(740) 354-5710
NPI assigned
Jul 22, 2014
Last updated
Nov 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul B. Bergsten, LNHA
Title
Ceo
Phone
(937) 825-6622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

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 1

  • Crystal Care Center of Portsmouth Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141113002004 OH Part A Provider - Skilled Nursing Facility 8628290251 Practice locations: Portsmouth, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215344288. Details of each certification follow.

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
CorporationProprietary
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

Care Compare: Nursing home

Medicare Care Compare
Listed as
River Run Healthcare of PortsmouthCCN 365867 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
2522.2 residents per day on average
Chain
Hillstone Healthcare9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Crystal Care Center of Portsmouth2 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.

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Whitney Berryman Individual W-2 Managing EmployeeAdministrator Dec 14, 2020
Paul B Bergsten Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2017 60%
Corporate OfficerCeo Sep 1, 2017
Corporate DirectorCeo Sep 1, 2017
Anthony Wheaton Individual Operational/Managerial Control Sep 1, 2014
Matthew Dapore Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2017 40%
Corporate OfficerCoo Sep 1, 2017
Corporate DirectorCoo Sep 1, 2017
Hillstone Healthcare Inc. Organization, Lewis Center, OH Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2017 100%

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1215344288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 SPRING ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623715",
            "telephone_number": "740-354-6619",
            "fax_number": "740-354-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SPRING ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623715",
            "telephone_number": "740-354-6619",
            "fax_number": "740-354-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENNA HEALTHCARE OF PORTSMOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "BERGSTEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-825-6622",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Care Center of Portsmouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.