Organization Active NPI

Ascc, LLC

  • Skilled Nursing Facility
  • Stockton, CA
National Provider Identifier
1639519986
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ASCC, LLC
Practice address
5320 Carrington Cir
Stockton, CA 95210-3515
Phone
(209) 473-3004
Fax
(209) 473-3329
NPI assigned
Jul 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Mr. Jeffrey Bradshaw
Title
Manager
Phone
(714) 548-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5320 Carrington Cir
Stockton, CA 95210-3515

Mailing address

28202 Cabot Rd
412
Laguna Niguel, CA 92677-1222
Phone (949) 347-7100

Other names 1

  • Riverwood Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131029000187 CA Part A Provider - Skilled Nursing Facility 0840425815 Practice locations: Stockton, CA

Skilled nursing facility certification: CCN 555496

Legal name
ASCC, LLC
Doing business as
RIVERWOOD HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1992
Last certification
Jul 25, 2024
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jun 25, 2013 in CA
Enrollment address
5320 Carrington Cir
Stockton, CA 95210-3515
Nursing home name
RIVERWOOD HEALTH CARE
Affiliated entity
ASPEN SKILLED HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Riverwood Health CareCCN 555496
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9989.5 residents per day on average
Chain
Aspen Skilled Healthcare35 facilities in the chain
Penalties (3 years)
12Fines totaling $47,637

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
05D0879478Riverwood Healthcare Center5320 Carrington Circle, Stockton, CA 95210Certificate of waiverNov 18, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Craig Orgill Individual Indirect Ownership Interest Jan 1, 2019 1.3%
Jared Kirkwood Individual Indirect Ownership Interest Jan 1, 2019 0.3%
Colton Rawe Individual Corporate OfficerLLC Manager Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Ascc, LLC Organization, Laguna Niguel, CA Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 27, 2014 100%
Operational/Managerial Control Jan 27, 2014
Adp of the SNF Jan 27, 2014
Eric Elsner Individual Indirect Ownership Interest Jan 27, 2014 4.08%
Jeffrey J Bradshaw Individual 5% Or Greater Indirect Ownership Interest Jun 25, 2013 22.25%
Adp of the SNF Jan 1, 2023
Reginald Goring Individual Operational/Managerial Control Mar 13, 2017
Adp of the SNF Mar 13, 2017
Organization, Laguna Beach, CA For-profit Adp of the SNF Jun 2, 2026
The Bryan C. Jennings and Sharon Jennings Revocable Living Trust Organization, Laguna Beach, CA For-profit Adp of the SNF Jan 1, 1986
Sequoia Healthcare Group LLC Organization, Laguna Niguel, CA LLC, Consulting firm, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2023 100%
Adp of the SNF Jan 1, 2023
Ryan M Case Individual 5% Or Greater Indirect Ownership Interest Jun 25, 2013 31.77%
Adp of the SNF Jan 1, 2023
Marcus J Paxman Individual Adp of the SNF Jan 1, 2023
Indirect Ownership Interest Apr 1, 2022 0.01%
Aspen Skilled Healthcare Inc Organization, Laguna Niguel, CA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 27, 2014 100%
Aspen Healthcare Services LLC Organization, Laguna Niguel, CA LLC, Consulting firm, Chain home office Adp of the SNF Jan 1, 2023
Wells Fargo Bank, National Association Organization, San Francisco, CA Corporation, Financial institution, For-profit Adp of the SNF Jan 27, 2014
Samuelott LLC Organization, Los Gatos, CA LLC 5% Or Greater Indirect Ownership Interest Jun 25, 2013 7%
Shivjitinder S Sidhu Individual Operational/Managerial Control Nov 1, 2020
Adp of the SNF Nov 1, 2020
Frank Jurado Individual Adp of the SNF Jan 1, 2023
Vern J Brady Individual 5% Or Greater Indirect Ownership Interest Jan 27, 2014 31.95%
Adp of the SNF Jan 1, 2023
Jenny Deperalta Individual Operational/Managerial Control Sep 29, 2022
Adp of the SNF Sep 29, 2022
Shruty Parti Individual Indirect Ownership Interest Jan 27, 2014 4.08%
Moss Adams LLP Organization, Irvine, CA For-profit Adp of the SNF Jan 27, 2014
Peter Bradshaw Individual Indirect Ownership Interest Jul 7, 2023 0.09%
Rajesh Parti Individual Indirect Ownership Interest Jan 27, 2014 4.08%

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 22

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

View all 22

Practitioners & affiliated clinicians

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": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1639519986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28202 CABOT RD",
            "address_2": "412",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926771222",
            "telephone_number": "949-347-7100",
            "fax_number": "949-347-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 CARRINGTON CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103515",
            "telephone_number": "209-473-3004",
            "fax_number": "209-473-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-548-8046",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwood Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverwood Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.