Organization Active NPI

Heisman LLC

  • Skilled Nursing Facility
  • Grass Valley, CA
National Provider Identifier
1346084399
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HEISMAN LLC
Practice address
355 Joerschke Dr
Grass Valley, CA 95945-5288
Phone
(530) 273-7247
NPI assigned
Jun 24, 2024
Last updated
Jun 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Authorized official

Name
Brandon Burkinshaw
Title
Coo
Phone
(480) 206-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

355 Joerschke Dr
Grass Valley, CA 95945-5288

Mailing address

2266 Lava Ridge CT Ste 105
Roseville, CA 95661-2856
Phone (480) 206-2229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611002715 CA Part A Provider - Skilled Nursing Facility 5890205405 Practice locations: Grass Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346084399. Details of each certification follow.

Skilled nursing facility certification: CCN 055640

Legal name
HEISMAN LLC
Doing business as
GRASS VALLEY HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 2, 1968
Last certification
Jun 9, 2023
Beds
86
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Cypress Healthcare Group
Organization structure
LLCProprietary
Enrollment address
355 Joerschke Dr
Grass Valley, CA 95945-5288
Nursing home name
GRASS VALLEY HEALTHCARE CENTER
Affiliated entity
CYPRESS HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grass Valley Healthcare CenterCCN 055640 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 2, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8683.3 residents per day on average
Chain
Cypress Healthcare Group13 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Cypress Healthcare Group LLC Organization, Roseville, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 30, 2024 100%
Matthew Jackson Individual 5% Or Greater Indirect Ownership Interest Dec 30, 2024 33.33%
Corporate OfficerManager Dec 30, 2024
Operational/Managerial Control Jun 24, 2026
Kuldip S Gill Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Robert Jackson Individual 5% Or Greater Indirect Ownership Interest Dec 30, 2024 33.33%
Corporate OfficerManager Dec 30, 2024
Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Jack Sanofsky Individual 5% Or Greater Indirect Ownership Interest Dec 30, 2024 33.33%
Corporate OfficerManager/President Dec 30, 2024
Operational/Managerial Control Jun 24, 2026
Matthew Webster Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 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 12

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1346084399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 LAVA RIDGE CT STE 105",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612856",
            "telephone_number": "480-206-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 JOERSCHKE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455288",
            "telephone_number": "530-273-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEISMAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "BURKINSHAW",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-206-2229"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.