Active NPI
Flagstaff Transitional Care, LLC
Doing business as Aspire Transitional Care
- Skilled Nursing Facility
- Flagstaff, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- FLAGSTAFF TRANSITIONAL CARE, LLC
- Doing business as
- Aspire Transitional Care
- Practice address
- 1521 N Pine Cliff Dr
Flagstaff, AZ 86001-3269 - Phone
- (928) 440-2350
- NPI assigned
- Mar 16, 2020
- Last updated
- Jul 7, 2020
- 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
- Randall W. Benson
- Title
- Authorized Official
- Phone
- (952) 361-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1521 N Pine Cliff Dr
Flagstaff, AZ 86001-3269
Mailing address
1107 Hazeltine Boulevard, Box 26
Chaska, MN 55318
Phone (952) 361-8900
Other names 1
- Aspire Transitional Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200824002281 | AZ | Part A Provider - Skilled Nursing Facility | 0244657161 | Practice locations: Flagstaff, AZ |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1407482920. Details of each certification follow.
Skilled nursing facility certification: CCN 035296
- Legal name
- FLAGSTAFF TRANSITIONAL CARE, LLC
- Doing business as
- ASPIRE TRANSITIONAL CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Oct 11, 2018
- Last certification
- Aug 22, 2024
- Beds
- 50
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- The Goodman Group
- Organization structure
- LLC
- Incorporated
- Feb 14, 2020 in AZ
- Enrollment address
- 1521 N Pine Cliff Dr
Flagstaff, AZ 86001-3269 - Nursing home name
- ASPIRE TRANSITIONAL CARE
- Affiliated entity
- THE GOODMAN GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Aspire Transitional Care
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- Oct 11, 2018
- Medicare certification status
- Active
- Certified beds
- 50
- Chain
- The Goodman Group
National Provider Directory
National Provider DirectoryLocations
1521 N Pine Cliff Dr
Flagstaff, AZ 86001
Phone (928) 440-2350
1107 Hazeltine Blvd
Unit 26
Chaska, MN 55318
Ownership & related parties
All disclosed owners & managing parties 11
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 |
|---|---|---|---|
| Flagstaff Transitional Care, LLC | 5% Or Greater Direct Ownership Interest | Feb 14, 2020 | 100% |
| Mark W Reiling | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| Clinton V Knacke | Corporate Officer | Oct 12, 2022 | 100% |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| Craig E Edinger | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| Thomas Jay Salmen | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Officer | Jan 1, 2024 | 33.33% | |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| Keith Mitchell Dorris | W-2 Managing Employee | Aug 1, 2020 | 100% |
| Mark L Wilson | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Officer | Jan 1, 2024 | 33.33% | |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| Sadek R Ebeid | Contracted Managing Employee | Aug 1, 2020 | |
| Shane Goodman | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Director | Jan 1, 2024 | 14.29% | |
| The Goodman Family Operating Foundation | 5% Or Greater Direct Ownership Interest | Jan 1, 2024 | 100% |
| James a Weichert | 5% Or Greater Indirect Ownership Interest | Jan 1, 2024 | 14.29% |
| Corporate Director | Jan 1, 2024 | 14.29% |
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 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba The Peaks Health & Rehabilitation
- Skilled Nursing Facility
- Flagstaff, AZ
- NPI 1679515449
The Goodman Family Operating Foundation
-
dba Discovery Care Centre
- Skilled Nursing Facility
- Hamilton, MT
- NPI 1689349987
The Goodman Family Operating Foundation
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.
-
- Hospitalist Physician
- Anthem, AZ
- NPI 1285955781
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": "1584316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1594080000000",
"number": "1407482920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 HAZELTINE BOULEVARD, BOX 26",
"city": "CHASKA",
"state": "MN",
"postal_code": "55318",
"telephone_number": "952-361-8900",
"fax_number": "952-361-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 N PINE CLIFF DR",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013269",
"telephone_number": "928-440-2350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLAGSTAFF TRANSITIONAL CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-16",
"last_updated": "2020-07-07",
"certification_date": "2020-07-07",
"status": "A",
"authorized_official_last_name": "BENSON",
"authorized_official_first_name": "RANDALL",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "952-361-8000"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Aspire Transitional Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Flagstaff, AZ
- Flagstaff Psychology and Counseling LLC
- Flagstaff Pulmonology PLLC
- Flagstaff Smiles LLC
- Flagstaff Speech Solutions, PLLC
- Flagstaff Surgical Associates PA
- Flagstaff Unified School District
- Flagstaff Unified School District
- Flagstaff Unified School District
- Flagstaff Unified School District #1
- Flagstaff Walk in Clinic LLC (Walk in Medical Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.