Active NPI
Del Oro LLC
Doing business as Gold Country Health Center
- Skilled Nursing Facility
- Placerville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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, 2022
- 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
- Dan Bushnell
- Title
- Director of Operations
- Phone
- (949) 508-8370
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 7, 1984
- Medicare certification status
- Active
- Certified beds
- 68
- Chain
- Cypress Healthcare Group
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Cypress Healthcare Group LLC | 5% Or Greater Direct Ownership Interest | Apr 1, 2023 | 100% |
| Sheryce Purdue | Operational/Managerial Control | Mar 11, 2024 | |
| Adp of the SNF | Mar 11, 2024 | ||
| Rosemarie Carino | Operational/Managerial Control | Apr 1, 2023 | |
| Adp of the SNF | Apr 1, 2023 | ||
| Gregory G Smith | Operational/Managerial Control | Apr 1, 2023 | |
| Adp of the SNF | Apr 1, 2023 | ||
| Negar Golshan | Operational/Managerial Control | Jan 8, 2024 | |
| Adp of the SNF | Jan 8, 2024 | ||
| Doug W Hawkins | Operational/Managerial Control | Apr 1, 2023 | |
| Adp of the SNF | Apr 1, 2023 | ||
| Sandhya Mala | Operational/Managerial Control | Jun 24, 2023 | |
| Adp of the SNF | Jun 24, 2023 | ||
| Melissia Cardella | Operational/Managerial Control | Aug 28, 2023 | |
| Adp of the SNF | Aug 28, 2023 | ||
| Matthew Jackson | 5% Or Greater Indirect Ownership Interest | Apr 1, 2023 | 33.33% |
| Corporate Officer | Apr 1, 2023 | ||
| Operational/Managerial Control | Apr 1, 2023 | ||
| Adp of the SNF | Apr 1, 2023 | ||
| Robert Jackson | 5% Or Greater Indirect Ownership Interest | Apr 1, 2023 | 33.33% |
| Corporate Officer | Apr 1, 2023 | ||
| Operational/Managerial Control | Apr 1, 2023 | ||
| Adp of the SNF | Apr 1, 2023 | ||
| Jack Sanofsky | 5% Or Greater Indirect Ownership Interest | Apr 1, 2023 | 33.33% |
| Corporate Officer | Apr 1, 2023 | ||
| Operational/Managerial Control | Apr 1, 2023 | ||
| Adp of the SNF | Apr 1, 2023 | ||
| Ken Crawford | Operational/Managerial Control | Oct 9, 2023 | |
| Adp of the SNF | Oct 9, 2023 | ||
| Martha Crane | 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.
-
- Internal Medicine Physician
- Sacramento, CA
- NPI 1952322596
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Pioneer House
- Skilled Nursing Facility
- Sacramento, CA
- NPI 1558082776
Cypress Healthcare Group LLC
-
dba Manzanita Healthcare Center
- Skilled Nursing Facility
- Carmichael, CA
- NPI 1548963127
Cypress Healthcare Group LLC
-
dba Greenhaven Healthcare Center
- Skilled Nursing Facility
- Sacramento, CA
- NPI 1437852027
Cypress Healthcare Group LLC
-
dba Saylor Lane Healthcare Center
- Skilled Nursing Facility
- Sacramento, CA
- NPI 1972147494
Cypress Healthcare Group LLC
-
dba Auburn Ravine Terrace
- Skilled Nursing Facility
- Auburn, CA
- NPI 1568183788
Cypress Healthcare Group LLC
-
dba Fair Oaks Healthcare Center
- Skilled Nursing Facility
- Fair Oaks, CA
- NPI 1396448882
Cypress Healthcare Group LLC
-
dba Sherwood Healthcare Center
- Skilled Nursing Facility
- Sacramento, CA
- NPI 1962046482
Cypress Healthcare Group LLC
-
dba Asbury Park Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Sacramento, CA
- NPI 1023652542
Cypress Healthcare Group LLC
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.