NPIMap

Organization Active NPI

Paradise Valley Health Care Center, Inc.

  • Skilled Nursing Facility
  • National City, CA
National Provider Identifier
1275513293
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
090000141 Issued in CA
Legal business name
PARADISE VALLEY HEALTH CARE CENTER, INC.
Practice address
2575 E 8TH St
National City, CA 91950-2913
Phone
(619) 470-6700
Fax
(619) 470-0404
NPI assigned
Jan 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 090000141 CA Primary

Addresses

Primary practice location

2575 E 8TH St
National City, CA 91950-2913

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other identifiers 2

IdentifierTypeStateIssuer
090000141OtherCACDPH FACILITY LICENSE NUMBER
LTC06388GMedicaidCA

Other names 1

  • PARADISE VALLEY HEALTH CARE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715000018 CA Part A Provider - Skilled Nursing Facility 0042246563 Practice locations: National City, CA

Skilled nursing facility certification: CCN 056388

Legal name
PARADISE VALLEY HEALTH CARE CENTER, INC
Doing business as
PARADISE VALLEY HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 31, 1973
Last certification
Nov 21, 2024
Beds
86
Ownership / control type
Corporation
Multi-facility organization
PACS
Organization structure
CorporationProprietary
Incorporated
Mar 5, 1992 in CA
Enrollment address
2575 East 8TH Street
National City, CA 91950-2913
Nursing home name
PARADISE VALLEY HEALTH CARE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Paradise Valley Health CareCCN 056388
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 31, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8680.8 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $10,036

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0721674Paradise Valley Health Care Center2575 E 8TH St, National City, CA 91950Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & 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.

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Troy H Niguidula Individual Contracted Managing EmployeeMD; Apr 1, 2018
Patrick L Burrup Individual W-2 Managing EmployeeAdministrator Nov 5, 2021
Operational/Managerial ControlAdministrator Nov 5, 2021
Andrew Aaron Burrup Individual Corporate OfficerPresident/Cfo/Secretary Sep 3, 2020
Corporate Director Sep 3, 2020
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

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 186

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

View all 186

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1275513293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502913",
            "telephone_number": "619-470-6700",
            "fax_number": "619-470-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "090000141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPH FACILITY LICENSE NUMBER",
            "identifier": "090000141",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC06388G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARADISE VALLEY HEALTH CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARADISE VALLEY HEALTH CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.