Bridgeport Way W Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BRIDGEPORT WAY W HEALTHCARE LLC

Doing business as

Agility Health and Rehabilitation

Practice address

5520 Bridgeport Way W
University Place, WA 98467-2041

Phone

(253) 566-7166

NPI assigned

Aug 8, 2023

Last updated

Aug 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Miller

Title

Ceo

Phone

(253) 268-2410

Specialties & licenses 1

Addresses

Other names 1

• Agility Health and Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417630351. Details of each certification follow.

• CCN 505473 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 505473

Legal name

BRIDGEPORT WAY W HEALTHCARE LLC

Doing business as

AGILITY HEALTH AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

May 1, 1992

Last certification

Apr 11, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Vertical Healthcare Services

Organization structure

LLCProprietary

Enrollment address

5520 Bridgeport Way W
University Place, WA 98467-2041

Nursing home name

AGILITY HEALTH AND REHABILITATION

Affiliated entity

VERTICAL HEALTH SERVICES

Listed as

Agility Health and RehabilitationCCN 505473 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120108.1 residents per day on average

Chain

Vertical Health Services15 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 1

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

• Joseph C Denor, MD

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1679548531

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 3

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.

• Amir Aref

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1063522126
  NPD (past)
• Neel Ramesh Chheda, DO

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1336678382
  NPD (past)
• Joseph C Denor, MD

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1679548531
  NPD (past)

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jessy Edgardo Ang Jr., M.D.

  • Family Medicine Physician
  • Lakewood, WA
  • NPI 1639518327

  Nursing home

  Care Compare affiliation
• Amir Aref

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1063522126

  Nursing home

  Care Compare affiliation
• Neel Ramesh Chheda, DO

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1336678382

  Nursing home

  Care Compare affiliation
• Martin J Iversen, M.D.

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1427036581

  Nursing home

  Care Compare affiliation
• Prakash Kharel, ARNP

  • Family Nurse Practitioner
  • Renton, WA
  • NPI 1114564275

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1417630351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15406 MERIDIAN E STE 201",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983759504",
            "telephone_number": "253-268-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984672041",
            "telephone_number": "253-566-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT WAY W HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-268-2410"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agility Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Robert Breaux, LPN
• Elizabeth Rose Breckow
• Dawn M Breikss, LMHC
• Bridgeport Dental Arts
• Bridgeport Place Assisted Living
• Yvonne Tiffany Briones
• Madalyn Brooke
• Carl Brooks III
• Kasandra Brooks, DC
• Mark F Brooks, MD

• Skilled Nursing Facility in University Place, WA
• Providers in University Place, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.

Verify at the official NPI Registry.