NPIMap

Organization Active NPI

Regency Coupeville, LLC

Doing business as Regency Coupeville

  • Skilled Nursing Facility
  • Coupeville, WA
National Provider Identifier
1508864935
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
REGENCY COUPEVILLE, LLC
Doing business as
Regency Coupeville
Regency Coupeville Rehabilitation and Nursing Center
Practice address
311 NE 3Rd St
Coupeville, WA 98239-3427
Phone
(360) 678-2273
Fax
(360) 678-0510
NPI assigned
Jul 10, 2005
Last updated
Feb 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Ali Williams
Title
Corporate Paralegal
Phone
(425) 623-1466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

311 NE 3Rd St
Coupeville, WA 98239-3427

Mailing address

311 NE 3Rd St
Coupeville, WA 98239-3427
Phone (360) 678-2273

Other identifiers 1

IdentifierTypeStateIssuer
604622050OtherWAUBI NUMBER

Other names 2

  • Regency Coupeville Doing business as
  • Regency Coupeville Rehabilitation and Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115001031 WA Part A Provider - Skilled Nursing Facility 2365855111 Practice locations: Coupeville, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508864935. Details of each certification follow.

Skilled nursing facility certification: CCN 505309

Legal name
REGENCY COUPEVILLE LLC
Doing business as
REGENCY COUPEVILLE REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 27, 1987
Last certification
Oct 29, 2024
Beds
112
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Regency Pacific Management
Organization structure
LLCProprietary
Incorporated
Jun 16, 2020 in WA
Enrollment address
311 NE 3Rd St
Coupeville, WA 98239-3427
Nursing home name
REGENCY COUPEVILLE REHAB AND NURSING CENTER
Affiliated entity
REGENCY PACIFIC MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Regency Coupeville Rehab and Nursing CenterCCN 505309 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 27, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11272.0 residents per day on average
Chain
Regency Pacific Management27 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
4Fines totaling $131,131

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Regency Coupeville2 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.

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
Andrew Rapp Individual Operational/Managerial Control Mar 8, 2016
Adp of the SNF Mar 8, 2016
Omnicare LLC Organization, Woonsocket, RI LLC, Medical provider/supplier Adp of the SNF Sep 1, 2013
Regency Pacific Management LLC Organization, Bellevue, WA LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Jun 16, 2020 100%
Adp of the SNF Aug 26, 2025
Regency Coupeville Properties I LLC Organization, Bellevue, WA LLC, For-profit Adp of the SNF Jun 16, 2020
Organization, Portland, OR Corporation, Consulting firm Adp of the SNF Jul 8, 2025
Organization, Portland, OR LLC, Consulting firm Adp of the SNF Jul 8, 2025
James Lee Clay Individual 5% Or Greater Direct Ownership Interest Jun 16, 2020 33.3%
Adp of the SNF Jun 16, 2020
Eric Moffitt Individual Operational/Managerial Control Aug 21, 2023
Adp of the SNF Aug 21, 2023
Caleb T Chu Individual Operational/Managerial Control Feb 2, 2023
Adp of the SNF Feb 2, 2023
David P Stroud Individual 5% Or Greater Direct Ownership Interest Jun 16, 2020 33.3%
Adp of the SNF Jun 16, 2020
Marvin B Beddoe Individual 5% Or Greater Direct Ownership Interest Jun 16, 2020 33.3%
Operational/Managerial Control Jun 16, 2020
Adp of the SNF Jun 16, 2020

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 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 2

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": "1120953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1508864935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 NE 3RD ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393427",
            "telephone_number": "360-678-2273",
            "fax_number": "360-678-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NE 3RD ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393427",
            "telephone_number": "360-678-2273",
            "fax_number": "360-678-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY COUPEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-10",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CORPORATE PARALEGAL",
        "authorized_official_telephone_number": "425-623-1466"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI NUMBER",
            "identifier": "604622050",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Coupeville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regency Coupeville Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.