NPIMap

Organization Active NPI

Sierra Nevada SNF, LLC

Doing business as Sierra Valley Rehab Center

  • Skilled Nursing Facility
  • Porterville, CA
National Provider Identifier
1356030001
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SIERRA NEVADA SNF, LLC
Doing business as
Sierra Valley Rehab Center
Practice address
301 W Putnam Ave
Porterville, CA 93257
Phone
(559) 784-7375
NPI assigned
May 8, 2023
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 Primary

Addresses

Primary practice location

301 W Putnam Ave
Porterville, CA 93257

Mailing address

262 N University Ave
Farmington, UT 84025
Phone (385) 518-1814

Other names 1

  • Sierra Valley Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240228003768 CA Part A Provider - Skilled Nursing Facility 7719322825 Practice locations: Porterville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356030001. Details of each certification follow.

Skilled nursing facility certification: CCN 055568

Legal name
SIERRA NEVADA SNF LLC
Doing business as
SIERRA VALLEY REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1974
Last certification
Feb 27, 2025
Beds
139
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 1, 2023 in CA
Enrollment address
301 W Putnam Ave
Porterville, CA 93257-3429
Nursing home name
SIERRA VALLEY REHAB CENTER
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sierra Valley Rehab CenterCCN 055568 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
139126.0 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $8,190

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
05D0585482Sierra Valley Rehab Center301 W Putnam Ave, Porterville, CA 93257Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

301 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-7375

Ownership & related parties

All disclosed owners & managing parties 14

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 May 1, 2023 35.2%
John T Mitchell Individual Operational/Managerial Control Jan 1, 2024
Organization, Torrance, CA LLC, For-profit Adp of the SNF Jun 15, 2023
Suneel H Wadhwani Individual Operational/Managerial Control Jun 15, 2023
Adp of the SNF Jul 16, 2025
Frederick G Apt Individual Operational/Managerial Control Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm, For-profit Adp of the SNF Jun 15, 2023
Mason Rasmussen Individual Operational/Managerial Control Jun 15, 2023
Adp of the SNF Jul 16, 2025
Truist Bank Organization, Charlotte, NC Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Dec 7, 2023 100%
Sandra Dotson Individual Operational/Managerial Control Jan 1, 2024
Joshua O Jergensen Individual Operational/Managerial Control Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 35.2%

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 4

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": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1356030001",
    "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": "84025",
            "telephone_number": "385-518-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W PUTNAM AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "93257",
            "telephone_number": "559-784-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA NEVADA SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Valley Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sierra Valley Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.