Blue Springs Wellness & Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BLUE SPRINGS WELLNESS & REHABILITATION LLC

Doing business as

Blue Springs Wellness & Rehabilitation

Practice address

930 NE Duncan Rd
Blue Springs, MO 64014-2173

Phone

(816) 229-6677

NPI assigned

Oct 8, 2024

Last updated

Oct 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Garetz

Title

Cfo

Phone

(323) 987-5954

Specialties & licenses 1

Addresses

Other names 1

• Blue Springs Wellness & Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639998479. Details of each certification follow.

• CCN 265595 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265595

Legal name

BLUE SPRINGS WELLNESS & REHABILITATION LLC

Doing business as

BLUE SPRINGS WELLNESS & REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1994

Last certification

Mar 28, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

PETERSEN HEALTH CARE

Most recent change of ownership

Dec 2, 2024

Organization structure

LLCProprietary

Enrollment address

930 NE Duncan Rd
Blue Springs, MO 64014-2173

Nursing home name

BLUE SPRINGS WELLNESS & REHABILITATION

Affiliated entity

OPCO SKILLED MANAGEMENT

Listed as

Blue Springs Wellness & RehabilitationCCN 265595 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Dec 1, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120106.1 residents per day on average

Chain

Opco Skilled Management66 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $96,959

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 16

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Richard Tam Chung, M.D.

  • Internal Medicine Physician
  • Blue Springs, MO
  • NPI 1104981026

  Adp of the SNF

  CMS ownership

Facilities with the same owner 4

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

• Blooming Oaks Wellness & Rehabilitation LLC

  dba Bluebird Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1699528422

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Maple Grove Wellness & Rehabilitation LLC

  dba Maple Grove Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Fenton, MO
  • NPI 1861231698

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Sage Nursing & Rehab LLC

  dba Magnolia Wellness Center

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1427897255

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership
• Willowcreek Wellness & Rehabilitation LLC

  dba Willowcreek Wellness & Rehabilitation

  • Skilled Nursing Facility
  • Florissant, MO
  • NPI 1780437517

  Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srinath Tadakamalla, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Harrisonville, MO
  • NPI 1184691305
  NPD (past)

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1639998479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 NE DUNCAN RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142173",
            "telephone_number": "816-229-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 NE DUNCAN RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142173",
            "telephone_number": "816-229-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SPRINGS WELLNESS & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "GARETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-987-5954"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Springs Wellness & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blue Springs Family Care PC
• Blue Springs Family Eye Care, Inc.
• Blue Springs Internal Medicine
• Blue Springs Psychological Services LLC
• Blue Springs R-IV School District
• Bluesprings Group Inc
• Gary E. Bodenhausen, M.D.
• Ben Boecklen
• Nathan Blair Boles, D.D.S.
• Samuel J Boone, OTR

• Skilled Nursing Facility in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.

Verify at the official NPI Registry.