NPIMap

Organization Active NPI

Watson Woods Healthcare, Inc.

  • Skilled Nursing Facility
  • Prescott, AZ
National Provider Identifier
1548640840
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WATSON WOODS HEALTHCARE, INC.
Practice address
1045 Scott Dr
Prescott, AZ 86301-1731
Phone
(928) 778-9603
Fax
(928) 778-5909
NPI assigned
Jun 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1045 Scott Dr
Prescott, AZ 86301-1731

Mailing address

1045 Scott Dr
Prescott, AZ 86301-1731
Phone (928) 778-9603

Other names 1

  • Granite Creek Health and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150828001882 AZ Part A Provider - Skilled Nursing Facility 9133435654 Practice locations: Prescott, AZ

Skilled nursing facility certification: CCN 035131

Legal name
WATSON WOODS HEALTHCARE, INC.
Doing business as
GRANITE CREEK HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 31, 1986
Last certification
Oct 2, 2024
Beds
128
Ownership / control type
Partnership
Multi-facility organization
Bandera Healthcare
Organization structure
CorporationProprietary
Incorporated
Mar 24, 2015 in NV
Enrollment address
1045 Scott Road
Prescott, AZ 86301-1731
Nursing home name
GRANITE CREEK HEALTH & REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Granite Creek Health & Rehabilitation CenterCCN 035131
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Jul 31, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
128104.4 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Esolutions Inc2 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 7

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

NameRoleSinceShare
John Albrechtsen Individual Corporate OfficerPresident of Watson Woods Mar 26, 2015
The Ensign Group Inc Organization, San Juan Capistrano, CA For-profit 5% Or Greater Indirect Ownership Interest Sep 25, 2006 100%
Forrest Peterson Individual Corporate DirectorSole Director Jan 1, 2019
Tamara Sturdevant Individual W-2 Managing EmployeeAdministrator of Watson Woods Jul 1, 2015
Operational/Managerial ControlAdministrator of Watson Woods Jul 1, 2015
Bandera Healthcare LLC Organization, San Juan Capistrano, CA For-profit 5% Or Greater Direct Ownership Interest Mar 25, 2015 100%
Craig Fitch Individual Corporate OfficerSecretary Jan 1, 2019
Soon Burnam Individual Corporate OfficerTreasurer of Watson Woods Mar 25, 2015

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1548640840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 SCOTT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011731",
            "telephone_number": "928-778-9603",
            "fax_number": "928-778-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 SCOTT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011731",
            "telephone_number": "928-778-9603",
            "fax_number": "928-778-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATSON WOODS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Granite Creek Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Granite Creek Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.