NPIMap

Organization Active NPI

Wildcreek Healthcare, Inc.

  • Skilled Nursing Facility
  • Reno, NV
National Provider Identifier
1407123417
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WILDCREEK HEALTHCARE, INC.
Practice address
2045 Silverada Blvd
Reno, NV 89512-2051
Phone
(775) 359-3161
Fax
(775) 331-2878
NPI assigned
Nov 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

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

Addresses

Primary practice location

2045 Silverada Blvd
Reno, NV 89512-2051

Mailing address

2045 Silverada Blvd
Reno, NV 89512-2051
Phone (775) 359-3161

Other names 1

  • Rosewood Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120306000412 NV Part A Provider - Skilled Nursing Facility 5890954184 Practice locations: Reno, NV

Skilled nursing facility certification: CCN 295020

Legal name
WILDCREEK HEALTHCARE, INC.
Doing business as
ROSEWOOD REHABILITAION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1970
Last certification
Oct 10, 2024
Beds
99
Ownership / control type
Corporation
Multi-facility organization
Ensign Services
Organization structure
CorporationProprietary
Incorporated
Sep 27, 2011 in NV
Enrollment address
2045 Silverada Blvd
Reno, NV 89512-2051
Nursing home name
ROSEWOOD REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rosewood Rehabilitation CenterCCN 295020 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 1, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9984.4 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

2045 Silverada Blvd
Reno, NV 89512
Phone (775) 359-3161

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Appalachian Speech Pathology Associates Inc Organization, Lenoir, NC Corporation Operational/Managerial Control Dec 2, 2011
Nursa Inc Organization, Los Angeles, CA Corporation Operational/Managerial Control Dec 2, 2011
Isaiah Hawkins Individual Corporate OfficerPresident Wildcreek Healthcare, Inc Sep 9, 2024
Pennant Healthcare LLC Organization, San Juan Capistrano, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2014 100%
Silverada Health Holdings LLC Organization, San Clemente, CA LLC Adp of the SNF Dec 2, 2011
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Dec 2, 2011
Ami Sato Individual Corporate OfficerTreasurer Wildcreek Healthcare, Inc Sep 9, 2024
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Dec 2, 2011
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Dec 2, 2011
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Dec 2, 2011
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Stephen W Farnsworth Individual Corporate OfficerDirector Wildcreek Healthcare, Inc. Jul 27, 2018
David Welker Individual Operational/Managerial Control Nov 1, 2022
Managing Control - Governing BodyAdministrator Nov 1, 2022
Adp of the SNF Nov 1, 2022
Mel C Magboo Individual Operational/Managerial Control Dec 15, 2015
Managing Control - Governing BodyMedical Director Dec 15, 2015
Adp of the SNF Dec 15, 2015
Soon Burnam Individual Corporate OfficerSecretary Wildcreek Healthcare, Inc Sep 27, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Mel C. Magboo, M.D.
    • Geriatric Medicine (Internal Medicine) Physician
    • Reno, NV
    • NPI 1114937158

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 32

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

View all 32

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1407123417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 SILVERADA BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895122051",
            "telephone_number": "775-359-3161",
            "fax_number": "775-331-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 SILVERADA BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895122051",
            "telephone_number": "775-359-3161",
            "fax_number": "775-331-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDCREEK HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rosewood Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rosewood Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.