Active NPI
Kellog of Cascadia, LLC
Doing business as Mountain Valley of Cascadia
- Skilled Nursing Facility
- Kellogg, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- KELLOG OF CASCADIA, LLC
- Doing business as
- Mountain Valley of Cascadia
- Practice address
- 601 W Cameron Ave
Kellogg, ID 83837-2004 - Phone
- (208) 784-1283
- NPI assigned
- Aug 22, 2017
- Last updated
- May 24, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | ID | Primary |
Addresses
Primary practice location
601 W Cameron Ave
Kellogg, ID 83837-2004
Mailing address
408 S Eagle Rd Ste 205
Eagle, ID 83616-6079
Phone (208) 401-9600
Other names 1
- Mountain Valley of Cascadia
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171106001603 | ID | Part A Provider - Skilled Nursing Facility | 3274899364 | Practice locations: Kellogg, ID |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1396261202. Details of each certification follow.
Skilled nursing facility certification: CCN 135065
- Legal name
- KELLOG OF CASCADIA LLC
- Doing business as
- MOUNTAIN VALLEY OF CASCADIA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 1, 1979
- Last certification
- May 1, 2025
- Beds
- 68
- Ownership / control type
- Corporation
- Multi-facility organization
- Cascadia Healthcare
- Most recent change of ownership
- Sep 1, 2017
- Organization structure
- LLC
- Enrollment address
- 601 W Cameron Ave
Kellogg, ID 83837-2004 - Nursing home name
- MOUNTAIN VALLEY OF CASCADIA
- Affiliated entity
- CASCADIA HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Mountain Valley of Cascadia
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 1, 1979
- Medicare certification status
- Active
- Certified beds
- 68
- Chain
- Cascadia Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0933598 | Mountain Valley of Cascadia | Certificate of waiver | Sep 15, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Cascadia Services LLC | Operational/Managerial Control | Nov 22, 2024 | |
| Adp of the SNF | Jan 23, 2025 | ||
| Cascadia HC Group LLC | Operational/Managerial Control | Jun 5, 2025 | |
| Indirect Ownership Interest | Jun 5, 2025 | 100% | |
| Emilee Kulin | Operational/Managerial Control | Sep 1, 2019 | |
| Adp of the SNF | Jun 18, 2025 | ||
| Cascadia Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | |
| Operational/Managerial Control | Sep 1, 2017 | ||
| Indirect Ownership Interest | Sep 1, 2017 | 100% | |
| Stephen J Laforte | Operational/Managerial Control | Jun 5, 2025 | |
| Indirect Ownership Interest | Jun 5, 2025 | 33.33% | |
| Owen C Hammond | Operational/Managerial Control | Jun 5, 2025 | |
| Indirect Ownership Interest | Sep 1, 2017 | 33.34% | |
| White Oak Healthcare Finance LLC | 5% Or Greater Security Interest | Aug 11, 2022 | |
| Michael G Meza | Operational/Managerial Control | Jul 1, 2018 | |
| Adp of the SNF | Feb 26, 2025 | ||
| Cascadia Holdco LLC | Operational/Managerial Control | Jun 5, 2025 | |
| Indirect Ownership Interest | Jun 5, 2025 | 100% | |
| Cascadia Idaho Operations LLC | 5% Or Greater Direct Ownership Interest | Sep 1, 2017 | |
| Operational/Managerial Control | Jun 5, 2025 | ||
| Direct Ownership Interest | Sep 1, 2017 | 100% | |
| Timothy Nelson | Operational/Managerial Control | Jun 5, 2025 | |
| Indirect Ownership Interest | Jun 5, 2025 | 33.33% | |
| Timberline Ctre Tenant LLC | 5% Or Greater Security Interest | Jun 5, 2025 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Coeur d'Alene, ID
- NPI 1134124506
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 46
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba The Cove of Cascadia
- Skilled Nursing Facility
- Bellevue, ID
- NPI 1861946436
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Cascadia of Boise
- Skilled Nursing Facility
- Boise, ID
- NPI 1295249241
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Arbor Valley of Cascadia
- Skilled Nursing Facility
- Boise, ID
- NPI 1063966638
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Eagle, ID
- NPI 1447960307
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Services LLC
-
dba Caldwell Care of Cascadia
- Skilled Nursing Facility
- Caldwell, ID
- NPI 1467978460
Cascadia Services LLC
-
dba Wellspring Health & Rehabilitation of Cascadia
- Skilled Nursing Facility
- Nampa, ID
- NPI 1699208280
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Caldwell, ID
- NPI 1770009680
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Orofino, ID
- NPI 1760925572
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Coeur d'Alene, ID
- NPI 1487197299
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
dba Cherry Ridge of Cascadia
- Skilled Nursing Facility
- Emmett, ID
- NPI 1497388003
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Grangeville, ID
- NPI 1740942622
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
-
- Skilled Nursing Facility
- Idaho Falls, ID
- NPI 1972220473
Cascadia HC Group LLC, Cascadia Healthcare LLC, Cascadia Holdco LLC, Cascadia Idaho Operations LLC, Cascadia Services LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Coeur d'Alene, ID
- NPI 1134124506
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": "1503360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716508800000",
"number": "1396261202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 S EAGLE RD STE 205",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166079",
"telephone_number": "208-401-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W CAMERON AVE",
"city": "KELLOGG",
"state": "ID",
"postal_code": "838372004",
"telephone_number": "208-784-1283"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLOG OF CASCADIA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-22",
"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": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"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": [
{
"organization_name": "Mountain Valley of Cascadia",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kellogg, ID
- Human Dynamics and Diagnostics
- Human Dynamics and Diagnostics PLLC
- Idaho Dept of Health & Welfare Reg 1 Amh
- Idaho Dept of Health & Welfare Reg 1 Amh PSR Kellogg
- John M McNulty MD PC
- Kellogg Drugs LLC
- Kellogg Physical Therapy Inc
- Kelli Jean Kenser, DPT
- Kindred Nursing Centers West, LLC (Kindred Nursing and Rehabilitation - Mountain Valley)
- Kohal Pharmacy Inc (Kohal Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.