Osage Valley Healthcare LLC

Organization Active NPI Skilled Nursing Facility · De Soto, KS

NPI 1487411898 · NPPES record last updated Mar 28, 2024

Key facts

NPI
1487411898
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
OSAGE VALLEY HEALTHCARE LLC
Practice address
33600 W 85TH St
De Soto, KS 66018-8118
Phone
(913) 583-1266
NPI assigned
Mar 1, 2024
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 1

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

Corporate family (same tax ID) 1

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

Practitioners 2

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

Affiliated clinicians 2

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

Medicare Care Compare: Nursing home

Listed as
Hillside Village of de Soto Rehabilitation and Nur CCN 175472
Overall star rating
★★★★★ 5 of 5
Health inspections
★★★★☆ 4 of 5
Staffing
★★★☆☆ 3 of 5
Quality measures
★★★★★ 5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 28, 2003
Medicare certification status
Active (Provider of Services file)
Certified beds
49 · 44.0 residents per day on average
Chain
The Ensign Group (342 facilities)

Source: Medicare Care Compare, processed Aug 1, 2026.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Skilled nursing facility certification: CCN 175472

Legal name
OSAGE VALLEY HEALTHCARE LLC
Doing business as
HILLSIDE VILLAGE OF DE SOTO REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 28, 2003
Last certification
Feb 20, 2024
Beds
95 (49 certified)
Ownership / control type
Corporation
Multi-facility organization
Osage Vally Healthcare LLC
Organization structure
LLC · Proprietary
Enrollment address
33600 W 85TH St
De Soto, KS 66018-8118
Nursing home name
HILLSIDE VILLAGE OF DE SOTO REHABILITATION AND NUR
Affiliated entity
THE ENSIGN GROUP

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Standard Bearer Healthcare Op LP
Organization · San Juan Capistrano, CA
Adp of the SNF May 1, 2024
Jessica N Lee
Individual
Operational/Managerial Control May 1, 2024
Managing Control - Governing Body
Medical Director
May 1, 2024
Adp of the SNF Apr 9, 2026
Ethan Dean
Individual
Operational/Managerial Control Aug 13, 2024
Managing Control - Governing Body
Administrator
Aug 13, 2024
Adp of the SNF Apr 9, 2026
The Ensign Group Inc
Organization · San Juan Capistrano, CA
Corporation
5% Or Greater Indirect Ownership Interest Feb 26, 2024 100%
Adp of the SNF May 1, 2024
Ensign Services Inc
Organization · San Juan Capistrano, CA
Corporation, For-profit
Adp of the SNF May 1, 2024
David Jorgensen
Individual
Operational/Managerial Control Feb 26, 2024
Gateway Healthcare LLC
Organization · San Juan Capistrano, CA
LLC
Direct Ownership Interest Feb 26, 2024 100%
Chad Keetch
Individual
Operational/Managerial Control Feb 26, 2024
Abbot Health Holdings LLC
Organization · San Juan Capistrano, CA
LLC
Adp of the SNF May 1, 2024
Soon Burnam
Individual
Operational/Managerial Control Feb 26, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240424000459 KS Part a Provider - Skilled Nursing Facility 9032558010 Practice locations: De Soto, KS

National Provider Directory

Tax ID family
Esolutions Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

33600 W 85TH St
De Soto, KS 66018-8118

Mailing address

33600 W 85TH St
De Soto, KS 66018-8118
Phone (913) 583-1266

Other names

  • Hillside Village of De Soto Rehabilitation and Nursing Center Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0NhinService/XDRReesponse_Service Other eSolutions Inc.

Other providers in De Soto, KS

All providers in De Soto, KS · Skilled Nursing Facility in Kansas

Sources for this page

Verify at the official NPI Registry.