Organization Active NPI

Lewiston North of Cascadia, LLC

  • Skilled Nursing Facility
  • Lewiston, ID
National Provider Identifier
1376205260
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LEWISTON NORTH OF CASCADIA, LLC
Practice address
2852 Juniper Dr
Lewiston, ID 83501-4719
Phone
(208) 748-7700
NPI assigned
Oct 8, 2021
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Owen Hammond
Title
President
Phone
(208) 401-9600

Specialties & licenses 1

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

Addresses

Primary practice location

2852 Juniper Dr
Lewiston, ID 83501-4719

Mailing address

2205 E Riverside Dr Ste 100
Eagle, ID 83616-7621
Phone (208) 401-9600

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service?_ga=2.256233603.927568683.1685978531-1808492320.1685978531 Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220429001605 ID Part A Provider - Skilled Nursing Facility 9739576356 Practice locations: Lewiston, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376205260. Details of each certification follow.

Skilled nursing facility certification: CCN 135145

Legal name
LEWISTON NORTH OF CASCADIA, LLC
Doing business as
CASCADIA OF LEWISTON
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jun 28, 2018
Last certification
Apr 3, 2025
Beds
34
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Cascadia Healthcare
Organization structure
LLCProprietary
Incorporated
Sep 20, 2021 in ID
Enrollment address
2852 Juniper Dr
Lewiston, ID 83501-4719
Nursing home name
CASCADIA OF LEWISTON
Affiliated entity
CASCADIA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cascadia of LewistonCCN 135145 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Jun 28, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3431.3 residents per day on average
Chain
Cascadia Healthcare46 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
13D2142619Lewiston North of Cascadia LLC2852 Juniper Dr, Lewiston, ID 83501Certificate of waiverJan 15, 2028

National Provider Directory

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
Cascadia Services LLC Organization, Eagle, ID LLC Operational/Managerial Control Mar 1, 2022
Adp of the SNF Mar 1, 2022
Cascadia HC Group LLC Organization, Eagle, ID LLC Operational/Managerial Control Jun 5, 2025
Indirect Ownership Interest Jun 5, 2025 100%
John Bradley Rudolph Individual Operational/Managerial Control Jul 3, 2025
Adp of the SNF Jul 17, 2025
Cascadia Healthcare LLC Organization, Eagle, ID LLC Operational/Managerial Control Mar 1, 2022
Indirect Ownership Interest Mar 1, 2022 100%
Stephen J Laforte Individual Operational/Managerial Control Jun 5, 2025
Indirect Ownership Interest Jun 5, 2025 33.33%
Owen C Hammond Individual Operational/Managerial Control Mar 1, 2022
Indirect Ownership Interest Mar 1, 2022 33.34%
Lewiston 2852 Realty, LLC Organization, New York, NY LLC, Owned by another organization or individual 5% Or Greater Security Interest Jun 5, 2025 100%
Adp of the SNF Jun 5, 2025
White Oak Healthcare Finance LLC Organization, New York, NY LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Mar 1, 2022 100%
Cascadia Holdco LLC Organization, Eagle, ID LLC Operational/Managerial Control Jun 5, 2025
Indirect Ownership Interest Jun 5, 2025 100%
Cascadia Idaho Operations LLC Organization, Eagle, ID LLC Operational/Managerial Control Mar 1, 2022
Direct Ownership Interest Mar 1, 2022 100%
Timothy Nelson Individual Operational/Managerial Control Jun 5, 2025
Indirect Ownership Interest Jun 5, 2025 33.33%
James R Burt Individual Operational/Managerial Control Jun 14, 2025
Adp of the SNF Jul 17, 2025

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 46

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

View all 46

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": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1376205260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 E RIVERSIDE DR STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167621",
            "telephone_number": "208-401-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 JUNIPER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014719",
            "telephone_number": "208-748-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWISTON NORTH OF CASCADIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-401-9600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service?_ga=2.256233603.927568683.1685978531-1808492320.1685978531",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.