Active NPI
McCall Healthcare LLC
- Skilled Nursing Facility
- McCall, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MCCALL HEALTHCARE LLC
- Practice address
- 418 Floyde St
McCall, ID 83638-4508 - Phone
- (208) 634-2112
- Fax
- (208) 634-3605
- NPI assigned
- May 24, 2018
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | ID | Primary |
Addresses
Primary practice location
418 Floyde St
McCall, ID 83638-4508
Mailing address
418 Floyde St
McCall, ID 83638-4508
Phone (208) 634-2112
Other names 1
- McCall Rehabilitation and Care Center
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180627003046 | ID | Part A Provider - Skilled Nursing Facility | 1658627005 | Practice locations: McCall, ID |
Skilled nursing facility certification: CCN 135082
- Legal name
- MCCALL HEALTHCARE, LLC
- Doing business as
- MCCALL REHABILITATION AND CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1981
- Last certification
- Jul 14, 2022
- Beds
- 65
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Ensign Group Inc.
- Organization structure
- LLC
- Incorporated
- May 17, 2018 in NV
- Enrollment address
- 418 Floyde St
McCall, ID 83638-4508 - Nursing home name
- MCCALL REHABILITATION AND CARE CENTER
- Affiliated entity
- THE ENSIGN GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- McCall Rehabilitation and Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1981
- Medicare certification status
- Active
- Certified beds
- 65
- Chain
- The Ensign Group
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Standard Bearer Healthcare Op LP | Adp of the SNF | Jan 1, 2022 | |
| Isaiah Hawkins | Corporate Officer | Sep 9, 2024 | |
| Pennant Healthcare, Inc. | 5% Or Greater Direct Ownership Interest | Dec 30, 2021 | 100% |
| The Ensign Group Inc | 5% Or Greater Indirect Ownership Interest | May 17, 2018 | 100% |
| Adp of the SNF | Jan 1, 2022 | ||
| Ami Sato | Corporate Officer | Sep 9, 2024 | |
| Floyde Health Holdings LLC | Adp of the SNF | Jan 1, 2022 | |
| Stephen W Farnsworth | Corporate Officer | Jan 1, 2023 | |
| Corporate Director | May 30, 2019 | ||
| Operational/Managerial Control | Jul 1, 2018 | ||
| Managing Control - Governing Body | Jul 1, 2018 | ||
| Adp of the SNF | Apr 8, 2025 | ||
| Soon Burnam | Corporate Officer | May 17, 2018 | |
| Daniel J Allen | Managing Control - Governing Body | Jul 1, 2022 | |
| Adp of the SNF | Apr 8, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Middleton, ID
- NPI 1720017247
Adp of the SNF, Managing Control - Governing Body
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Middleton, ID
- NPI 1720017247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663113600000",
"number": "1609367697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 FLOYDE ST",
"city": "MCCALL",
"state": "ID",
"postal_code": "836384508",
"telephone_number": "208-634-2112",
"fax_number": "208-634-3605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "418 FLOYDE ST",
"city": "MCCALL",
"state": "ID",
"postal_code": "836384508",
"telephone_number": "208-634-2112",
"fax_number": "208-634-3605"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCCALL HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-05-24",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"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": "ID",
"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": "McCall Rehabilitation and Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in McCall, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.