Organization Active NPI

Flagstaff Transitional Care, LLC

Doing business as Aspire Transitional Care

  • Skilled Nursing Facility
  • Flagstaff, AZ
National Provider Identifier
1407482920
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCNon-profit
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 CareCCN 035296 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Oct 11, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5042.4 residents per day on average
Chain
The Goodman Group9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Flagstaff Transitional Care, LLC Organization, Chaska, MN Created for acquisition, LLC, Non-profit 5% Or Greater Direct Ownership Interest Feb 14, 2020 100%
Mark W Reiling Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 14.29%
Corporate Director Jan 1, 2024 14.29%
Clinton V Knacke Individual Corporate OfficerChief Financial Officer Oct 12, 2022 100%
Corporate Director Jan 1, 2024 14.29%
Craig E Edinger Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 14.29%
Corporate Director Jan 1, 2024 14.29%
Thomas Jay Salmen Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 14.29%
Corporate OfficerSecretary Jan 1, 2024 33.33%
Corporate Director Jan 1, 2024 14.29%
Keith Mitchell Dorris Individual W-2 Managing EmployeeExecutive Director Aug 1, 2020 100%
Mark L Wilson Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 14.29%
Corporate OfficerPresident Jan 1, 2024 33.33%
Corporate Director Jan 1, 2024 14.29%
Sadek R Ebeid Individual Contracted Managing EmployeeMD; Aug 1, 2020
Shane Goodman Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 14.29%
Corporate DirectorExecutive Chairman/Director Jan 1, 2024 14.29%
The Goodman Family Operating Foundation Organization, Chaska, MN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2024 100%
James a Weichert Individual 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.

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.

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

Sources for this page

Verify at the official NPI Registry.