NPIMap

Organization Active NPI

Regency Omak LLC

  • Skilled Nursing Facility
  • Omak, WA
National Provider Identifier
1306869722
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH 1479 Issued in WA
Legal business name
REGENCY OMAK LLC
Practice address
901 Shumway Rd
Omak, WA 98841-9798
Phone
(509) 846-7700
Fax
(509) 826-5248
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Marvin Beddoe
Title
Cfo
Phone
(425) 392-4066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH 1479 WA Primary

Addresses

Primary practice location

901 Shumway Rd
Omak, WA 98841-9798

Mailing address

3326 160TH Ave SE
Suite 120
Bellevue, WA 98008-6418
Phone (425) 392-4066

Other identifiers 2

IdentifierTypeStateIssuer
4114796MedicaidWA
173924OtherWAL&I NUMBER

Other names 1

  • Regency Omak Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141204000810 WA Part A Provider - Skilled Nursing Facility 5890017719 Practice locations: Omak, WA

Skilled nursing facility certification: CCN 505303

Legal name
REGENCY OMAK LLC
Doing business as
REGENCY OMAK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 28, 1986
Last certification
Oct 11, 2024
Beds
56
Ownership / control type
Corporation
Multi-facility organization
Regency Pacific Management
Organization structure
LLCProprietary
Incorporated
Jun 16, 2010 in WA
Enrollment address
901 Shumway Rd
Omak, WA 98841-9798
Nursing home name
REGENCY OMAK
Affiliated entity
REGENCY PACIFIC MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Regency OmakCCN 505303
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 28, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5641.6 residents per day on average
Chain
Regency Pacific Management27 facilities in the chain

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
50D0714668Regency Omak901 Shumway Rd, Omak, WA 98841Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

219 Cedar Ave S
North Bend, WA 98045
Phone (425) 888-2129

901 Shumway Rd
Omak, WA 98841
Phone (509) 826-1196

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Regency Pacific Management LLC Organization, Bellevue, WA LLC, Management services company, For-profit Operational/Managerial Control Nov 1, 2014 100%
James Lee Clay Individual 5% Or Greater Direct Ownership Interest Jun 16, 2010 50%
Marvin B Beddoe Individual 5% Or Greater Direct Ownership Interest Jun 16, 2010 50%
Operational/Managerial ControlCeo Nov 1, 2014 100%

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 10

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1306869722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 160TH AVE SE",
            "address_2": "SUITE 120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980086418",
            "telephone_number": "425-392-4066",
            "fax_number": "425-623-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SHUMWAY RD",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419798",
            "telephone_number": "509-846-7700",
            "fax_number": "509-826-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY OMAK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "BEDDOE",
        "authorized_official_first_name": "MARVIN",
        "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": "NH 1479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114796",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "173924",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Omak",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.