NPIMap

Organization Active NPI

Central Avenue Healthcare, Inc.

Doing business as Clarion Wellness and Rehabilitation Center

  • Skilled Nursing Facility
  • Clarion, IA
National Provider Identifier
1295029734
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CENTRAL AVENUE HEALTHCARE, INC.
Doing business as
Clarion Wellness and Rehabilitation Center
Practice address
110 13TH Ave SW
Clarion, IA 50525-2004
Phone
(515) 532-2893
Fax
(515) 532-2782
NPI assigned
Jun 1, 2011
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Ms. Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X IA Primary

Addresses

Primary practice location

110 13TH Ave SW
Clarion, IA 50525-2004

Mailing address

110 13TH Ave SW
Clarion, IA 50525-2004
Phone (515) 532-2893

Other names 1

  • Clarion Wellness and Rehabilitation Center 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 IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110720000084 IA Part A Provider - Skilled Nursing Facility 1153599022 Practice locations: Clarion, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295029734. Details of each certification follow.

Skilled nursing facility certification: CCN 165362

Legal name
CENTRAL AVENUE HEALTHCARE, INC.
Doing business as
CLARION WELLNESS AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 17, 1997
Last certification
Oct 17, 2024
Beds
76
Ownership / control type
Corporation
Multi-facility organization
Gateway Healthcare
Organization structure
CorporationProprietary
Enrollment address
110 13TH Ave SW
Clarion, IA 50525-2004
Nursing home name
CLARION WELLNESS AND REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clarion Wellness and Rehabilitation CenterCCN 165362 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 17, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7663.6 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $24,174

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
16D0669040Clarion Wellness & Rehabilitation Center110 13TH Avenue SW, Clarion, IA 50525Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

110 13th Ave SW
Clarion, IA 50525
Phone (515) 532-2893

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Onshift Inc Organization, Dallas, TX Corporation Operational/Managerial Control Jul 18, 2011
Dustin Smith Individual Operational/Managerial Control Jan 8, 2020
Managing Control - Governing BodyMedical Director Jan 8, 2020
Adp of the SNF Jul 12, 2025
The Ensign Group Inc Organization, Mission Viejo, CA LLC 5% Or Greater Indirect Ownership Interest Jul 18, 2011 100%
Adp of the SNF Jul 18, 2011
Helping Hands Nursing Solution Inc Organization, Sioux City, IA Corporation Operational/Managerial Control Jul 18, 2011
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Jun 1, 2011
Ami Sato Individual Corporate OfficerTreasurer Central Avenue Healthcare Sep 9, 2024
Elohim Medical Staffing Agency Inc Organization, Urbandale, IA Corporation Operational/Managerial Control Jul 18, 2011
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Jul 18, 2011
David Jorgensen Individual Corporate DirectorDirector Central Avenue Healthcare Sep 9, 2024
Gateway Healthcare LLC Organization, Mission Viejo, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Jul 18, 2011 100%
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Jul 18, 2011
Debra K Koenig Individual Corporate OfficerPresident Central Avenue Healthcare Sep 9, 2024
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Jul 18, 2011
Gazebo Park Health Holdings LLC Organization, Mission Viejo, CA LLC Adp of the SNF Jul 18, 2011
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Aerofund Holdings Inc Organization, San Jose, CA Corporation Operational/Managerial Control Jul 18, 2011
Spencer Cozzens Individual Operational/Managerial ControlAdministrator Sep 30, 2015
Managing Control - Governing BodyAdministrator Sep 30, 2015
Adp of the SNF Jul 11, 2025
Soon Burnam Individual Corporate OfficerSecretary Central Avenue Healthcare Jul 18, 2011
Managing Control - Governing BodyAuthorized Official Jul 18, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Dustin R Smith, MD
    • Family Medicine Physician
    • Eagle Grove, IA
    • NPI 1134191018

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1295029734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252004",
            "telephone_number": "515-532-2893",
            "fax_number": "515-532-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252004",
            "telephone_number": "515-532-2893",
            "fax_number": "515-532-2782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL AVENUE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "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": "2.16.840.1.113833.3.1066.1",
            "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": "Clarion Wellness and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarion Wellness and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarion, IA

Sources for this page

Verify at the official NPI Registry.