NPIMap

Organization Active NPI

Three Rocks Healthcare LLC

  • Community Based Hospice Care Agency
  • Lincoln City, OR
National Provider Identifier
1407679145
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
THREE ROCKS HEALTHCARE LLC
Practice address
794 SE Highway 101
Lincoln City, OR 97367-2715
Phone
(541) 264-7823
Fax
(541) 283-0150
NPI assigned
Nov 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

794 SE Highway 101
Lincoln City, OR 97367-2715

Mailing address

794 SE Highway 101
Lincoln City, OR 97367-2715

Other names 1

  • Signature Healthcare at Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250603001753 OR Part A Provider - Hospice 9931638749 Practice locations: Lincoln City, OR

Hospice certification: CCN 381583

Legal name
THREE ROCKS HEALTHCARE LLC
Doing business as
SIGNATURE HEALTHCARE AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 13, 2022
Last certification
Nov 30, 2022
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Enrollment address
794 SE Highway 101
Lincoln City, OR 97367-2715

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Signature Healthcare at HomeCCN 381583
Certified
Dec 13, 2022
Medicare certification status
ActiveFrom the Provider of Services file

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
38D2227454Three Rocks Healthcare LLC Dba794 SE Highway 101, Lincoln City, OR 97367Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Signature Healthcare at Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

794 SE Highway 101
Lincoln City, OR 97367
Phone (541) 264-7823

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Travis Wood Individual W-2 Managing EmployeeAd;Executive Director/Administrator Jun 4, 2026
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2025 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Karen T Kahn Individual W-2 Managing EmployeeMD; Dec 12, 2025
Brent Guerisoli Individual Corporate DirectorDirector & Sole Board Member May 1, 2025
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
John J Gochnour Individual Corporate OfficerPresident / LLC Manager May 1, 2025
Amber Tueller Individual Corporate OfficerSecretary May 1, 2025
Elliot McMillan Individual Corporate OfficerVice President May 1, 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 141

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

View all 141

Change-of-ownership history 1

DateEventCounterparty
May 1, 2025 Change of OwnershipThis provider was the buyer Signature Healthcare at HomeCCN 381583, OR, NPI 1508463274

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1407679145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 SE HIGHWAY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 SE HIGHWAY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672715",
            "telephone_number": "541-264-7823",
            "fax_number": "541-283-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE ROCKS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.