NPIMap

Organization Active NPI

12TH Street Operations, LLC

  • Skilled Nursing Facility
  • Rocky Ford, CO
National Provider Identifier
1346697471
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
12TH STREET OPERATIONS, LLC
Practice address
900 S 12TH St
Rocky Ford, CO 81067-2128
Phone
(619) 876-9252
NPI assigned
May 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Authorized official

Name
Rachel Silver
Title
Director of a/R-Colorado
Phone
(619) 876-9252

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Skilled Nursing Facility 314000000X Primary
Respite Care 385H00000X

Addresses

Primary practice location

900 S 12TH St
Rocky Ford, CO 81067-2128

Mailing address

26522 La Alameda Ste 300
Mission Viejo, CA 92691-8302
Phone (949) 449-2500

Other identifiers 2

IdentifierTypeStateIssuer
33155071MedicaidCO
9000142633MedicaidCO

Other names 1

  • Pioneer Health Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170731002419 CO Part A Provider - Skilled Nursing Facility 3375814957 Practice locations: Rocky Ford, CO
O20241120004429 CO Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3375814957 Practice locations: Rocky Ford, CO

Skilled nursing facility certification: CCN 065235

Legal name
12TH STREET OPERATIONS, LLC
Doing business as
PIONEER HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1987
Last certification
Apr 18, 2024
Beds
101
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Madison Creek Partners LLC
Most recent change of ownership
Jul 1, 2016
Organization structure
LLC
Incorporated
Apr 17, 2016 in CO
Enrollment address
900 S 12TH St
Rocky Ford, CO 81067-2128
Nursing home name
PIONEER HEALTH CARE CENTER
Affiliated entity
MADISON CREEK PARTNERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pioneer Health Care CenterCCN 065235
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10177.5 residents per day on average
Chain
Madison Creek Partners13 facilities in the chain
Penalties (3 years)
1Fines totaling $10,033

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
12TH Street Operations LLC2 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 12

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

NameRoleSinceShare
Chief Joseph Trail, LLC Organization, Mission Viejo, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 2, 2026 100%
Covey C Christensen Individual 5% Or Greater Indirect Ownership Interest Mar 2, 2026 82.5%
Operational/Managerial Control Jul 1, 2016
Adp of the SNF Jul 1, 2016
Cameron Cook Individual Operational/Managerial Control Feb 27, 2025
Adp of the SNF Feb 27, 2025
Organization, Mission Viejo, CA LLC Adp of the SNF Jul 1, 2016
White Canyon, LLC Organization, Grand Junction, CO LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 2, 2026 17.5%
Madison Creek Partners LLC Organization, Mission Viejo, CA For-profit Operational/Managerial Control Jul 1, 2016
Adp of the SNF Mar 30, 2026
John P. Ikerd Individual Operational/Managerial Control Apr 25, 2022
Managing Control - Governing BodySecretary Mar 2, 2026
Adp of the SNF Apr 25, 2022
Amber M Hopkins Individual Operational/Managerial Control Dec 1, 2021
Adp of the SNF Dec 1, 2021
Organization, Mission Viejo, CA LLC, Holding company Adp of the SNF Jul 1, 2016
David C Shepherd Individual Operational/Managerial Control Jun 1, 2022
Adp of the SNF Jun 1, 2022
Michael Joseph Clegg Individual 5% Or Greater Indirect Ownership InterestPresident Mar 2, 2026 17.5%
Operational/Managerial Control Jun 26, 2023
Managing Control - Governing BodyPresident Jun 26, 2023
Adp of the SNF Jun 26, 2023
Tippet, LLC Organization, Corona del Mar, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 2, 2026 82.5%

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 11

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": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1346697471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA STE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918302",
            "telephone_number": "949-449-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S 12TH ST",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810672128",
            "telephone_number": "619-876-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "12TH STREET OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR OF A/R-COLORADO",
        "authorized_official_telephone_number": "619-876-9252"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33155071",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000142633",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Ford, CO

Sources for this page

Verify at the official NPI Registry.