Organization Active NPI

Del Oro LLC

Doing business as Gold Country Health Center

  • Skilled Nursing Facility
  • Placerville, CA
National Provider Identifier
1639890627
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DEL ORO LLC
Doing business as
Gold Country Health Center
Practice address
4301 Golden Center Dr
Placerville, CA 95667-6260
Phone
(830) 621-1100
NPI assigned
Sep 7, 2022
Last updated
Sep 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Dan Bushnell
Title
Director of Operations
Phone
(949) 508-8370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4301 Golden Center Dr
Placerville, CA 95667-6260

Mailing address

2266 Lava Ridge CT
Roseville, CA 95661-2856
Phone (949) 508-8370

Other names 1

  • Gold Country Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230717000876 CA Part A Provider - Skilled Nursing Facility 9739549270 Practice locations: Placerville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639890627. Details of each certification follow.

Skilled nursing facility certification: CCN 555180

Legal name
DEL ORO LLC
Doing business as
GOLD COUNTRY HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 7, 1984
Last certification
Sep 26, 2024
Beds
68
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 20, 2022 in CA
Enrollment address
4301 Golden Center Dr
Placerville, CA 95667-6260
Nursing home name
GOLD COUNTRY HEALTH CENTER
Affiliated entity
CYPRESS HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gold Country Health CenterCCN 555180 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 7, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6864.3 residents per day on average
Chain
Cypress Healthcare Group13 facilities in the chain
Penalties (3 years)
2Fines totaling $14,886

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Cypress Healthcare Group LLC Organization, Roseville, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2023 100%
Sheryce Purdue Individual Operational/Managerial Control Mar 11, 2024
Adp of the SNF Mar 11, 2024
Rosemarie Carino Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Gregory G Smith Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Negar Golshan Individual Operational/Managerial Control Jan 8, 2024
Adp of the SNF Jan 8, 2024
Doug W Hawkins Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Sandhya Mala Individual Operational/Managerial Control Jun 24, 2023
Adp of the SNF Jun 24, 2023
Melissia Cardella Individual Operational/Managerial Control Aug 28, 2023
Adp of the SNF Aug 28, 2023
Matthew Jackson Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2023 33.33%
Corporate OfficerManager Apr 1, 2023
Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Robert Jackson Individual 5% Or Greater Indirect Ownership InterestManager Apr 1, 2023 33.33%
Corporate OfficerManager Apr 1, 2023
Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Jack Sanofsky Individual 5% Or Greater Indirect Ownership InterestManager Apr 1, 2023 33.33%
Corporate OfficerManager Apr 1, 2023
Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Ken Crawford Individual Operational/Managerial Control Oct 9, 2023
Adp of the SNF Oct 9, 2023
Martha Crane Individual Operational/Managerial Control Feb 5, 2024
Adp of the SNF Feb 5, 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 12

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

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": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1639890627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 LAVA RIDGE CT",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612856",
            "telephone_number": "949-508-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GOLDEN CENTER DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676260",
            "telephone_number": "830-621-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL ORO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "BUSHNELL",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "949-508-8370"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Country Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.