NPIMap

Organization Active NPI

Palm Valley Healthcare, LLC

  • Skilled Nursing Facility
  • Goodyear, AZ
National Provider Identifier
1558072645
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PALM VALLEY HEALTHCARE, LLC
Practice address
13575 W McDowell Rd
Goodyear, AZ 85395-2604
Phone
(623) 536-9911
NPI assigned
Dec 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Authorized official

Name
Alicia Cepeda
Title
Senior Legal/Risk Manager
Phone
(385) 342-5175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

13575 W McDowell Rd
Goodyear, AZ 85395-2604

Mailing address

13575 W McDowell Rd
Goodyear, AZ 85395-2604

Other names 1

  • Palm Valley Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230804001514 AZ Part A Provider - Skilled Nursing Facility 7618338740 Practice locations: Goodyear, AZ

Skilled nursing facility certification: CCN 035255

Legal name
PALM VALLEY HEALTHCARE, LLC
Doing business as
PALM VALLEY POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 28, 1999
Last certification
Feb 6, 2025
Beds
180
Ownership / control type
Corporation
Multi-facility organization
PACS
Organization structure
LLCProprietary
Incorporated
Nov 29, 2022 in AZ
Enrollment address
13575 W McDowell Rd
Goodyear, AZ 85395-2604
Nursing home name
PALM VALLEY POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Palm Valley Post AcuteCCN 035255
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 28, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180166.8 residents per day on average
Chain
Pacs Group274 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
1Fines totaling $82,607

Processed by Care Compare on Aug 1, 2026.

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
03D0979712Palm Valley Healthcare LLC13575 W McDowell Rd, Goodyear, AZ 85395AccreditationApr 20, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2023 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
William Nassour Individual Contracted Managing EmployeeMD; Apr 9, 2015
Terry Speth Individual W-2 Managing EmployeeAdministrator Mar 1, 2023
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

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 80

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

View all 80

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.

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1558072645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13575 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13575 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952604",
            "telephone_number": "623-536-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM VALLEY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "CEPEDA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "SENIOR LEGAL/RISK MANAGER",
        "authorized_official_telephone_number": "385-342-5175"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Valley Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palm Valley Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.