Active NPI
Sunnyside Operations LLC
Doing business as Avamere Transitional Care at Sunnyside
- Skilled Nursing Facility
- Salem, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SUNNYSIDE OPERATIONS LLC
- Doing business as
- Avamere Transitional Care at Sunnyside
- Practice address
- 4515 Sunnyside Rd SE
Salem, OR 97302-3928 - Phone
- (503) 370-8284
- NPI assigned
- Jan 23, 2014
- Last updated
- Feb 19, 2025
- 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
- Mary E. Kofstad
- Title
- Ceo
- Phone
- (971) 224-2033
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
4515 Sunnyside Rd SE
Salem, OR 97302-3928
Mailing address
25117 SW Parkway Ave
Suite F
Wilsonville, OR 97070-9697
Phone (503) 570-3405
Other names 1
- Avamere Transitional Care at Sunnyside
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140325000310 | OR | Part A Provider - Skilled Nursing Facility | 8325279912 | Practice locations: Salem, OR |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1699198812. Details of each certification follow.
Skilled nursing facility certification: CCN 385189
- Legal name
- SUNNYSIDE OPERATIONS LLC
- Doing business as
- AVAMERE TRANSITIONAL CARE AT SUNNYSIDE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 24, 1989
- Last certification
- Jun 6, 2025
- Beds
- 88
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Jun 1, 2014
- Organization structure
- LLC
- Enrollment address
- 4515 Sunnyside Road SE
Salem, OR 97302-3928 - Nursing home name
- AVAMERE TRANSITIONAL CARE AT SUNNYSIDE
- Affiliated entity
- AVAMERE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Avamere Transitional Care at Sunnyside
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 24, 1989
- Medicare certification status
- Active
- Certified beds
- 88
- Chain
- Avamere
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0937509 | Avamere Transitional Care at Sunnyside | Certificate of waiver | Dec 31, 2027 |
National Provider Directory
National Provider DirectoryLocations
4515 Sunnyside Rd SE
Salem, OR 97302
Phone (503) 307-8284
Ownership & related parties
All disclosed owners & managing parties 45
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 |
|---|---|---|---|
| Avamere Skilled Advisors LLC | Operational/Managerial Control | Jun 1, 2014 | |
| Adp of the SNF | Jul 14, 2025 | ||
| Sabra Health Care Reit Inc | Adp of the SNF | Aug 17, 2017 | |
| Michelle Funderberg | Managing Control - Governing Body | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Karl Rickard Miller | Indirect Ownership Interest | Jun 1, 2014 | 100% |
| Adp of the SNF | Aug 7, 2015 | ||
| Adp of the SNF | Jul 13, 2025 | ||
| Ari Operations, LLC | Indirect Ownership Interest | Jun 1, 2014 | 100% |
| Jennifer Dana | Operational/Managerial Control | May 1, 2022 | |
| Adp of the SNF | May 1, 2022 | ||
| Adp of the SNF | Jul 13, 2025 | ||
| Diane Vangorder | Operational/Managerial Control | Dec 1, 2023 | |
| Adp of the SNF | Dec 1, 2023 | ||
| Midcap Finco LLC | 5% Or Greater Security Interest | May 30, 2014 | |
| Operational/Managerial Control | May 30, 2014 | ||
| Glen Robert Cavallo | Managing Control - Governing Body | Jun 1, 2025 | |
| Ariso LLC | Direct Ownership Interest | Jun 1, 2014 | 100% |
| Michael Seifert | Operational/Managerial Control | Apr 14, 2025 | |
| Adp of the SNF | Jun 1, 2026 | ||
| Carolyn Staples | Managing Control - Governing Body | Oct 1, 2025 | |
| Adp of the SNF | Oct 1, 2025 | ||
| Karl Rickard Miller Jr Revocable Trust | Indirect Ownership Interest | Jun 1, 2014 | 100% |
| Avamere Health Services LLC | Operational/Managerial Control | Jun 1, 2014 | |
| Adp of the SNF | Jul 13, 2025 | ||
| Snapmedtech,Inc. | Adp of the SNF | Sep 8, 2025 | |
| Adp of the SNF | Aug 17, 2017 | ||
| Todd Inskeep | Managing Control - Governing Body | Jun 1, 2025 | |
| Adp of the SNF | Jan 21, 2022 | ||
| Consolidated Billing Services Inc | Adp of the SNF | Jun 1, 2014 | |
| Roberto Garcia | Operational/Managerial Control | Feb 1, 2026 | |
| Managing Control - Governing Body | Feb 1, 2026 | ||
| Adp of the SNF | Feb 1, 2026 | ||
| Colby Strunk | Managing Control - Governing Body | Jun 1, 2025 | |
| Adp of the SNF | Sep 6, 2022 | ||
| Loriel Fanunal | Operational/Managerial Control | Jan 2, 2023 | |
| Adp of the SNF | Jan 2, 2023 | ||
| Shannon Becerra | Adp of the SNF | Feb 1, 2025 | |
| Dustin J. Gibbins | Operational/Managerial Control | Jul 1, 2025 | |
| Adp of the SNF | Jul 1, 2025 | ||
| Kim Games | Adp of the SNF | Aug 15, 2024 | |
| Rande Holdings, LLC | Adp of the SNF | Jun 1, 2024 | |
| Avamere Group LLC | Indirect Ownership Interest | Jun 1, 2014 | 100% |
| Tonia Hoskins | Operational/Managerial Control | Jul 19, 2024 | |
| Adp of the SNF | Jun 1, 2025 | ||
| Mary Kofstad | Operational/Managerial Control | Feb 13, 2024 | |
| Managing Control - Governing Body | Jun 1, 2025 | ||
| Sabra Health Care Limited Partnership | Adp of the SNF | Aug 17, 2017 | |
| Yolanda Presley | Operational/Managerial Control | Jan 6, 2025 | |
| Adp of the SNF | Jan 6, 2025 | ||
| Nathan M Ruden | Operational/Managerial Control | Sep 1, 2023 | |
| Adp of the SNF | Jun 1, 2023 | ||
| Incovate Solutions, LLC | Adp of the SNF | Jan 21, 2022 | |
| Adp of the SNF | Aug 17, 2017 | ||
| Cody Feakin | Managing Control - Governing Body | Jun 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Adp of the SNF | Jul 13, 2025 | ||
| Misty Dawn Reid | Operational/Managerial Control | Jan 2, 2025 | |
| Managing Control - Governing Body | Jun 1, 2025 | ||
| Adp of the SNF | Jan 2, 2025 | ||
| Debra Scott | Adp of the SNF | Aug 1, 2025 | |
| Sabra Health Care, LLC | Adp of the SNF | Aug 17, 2017 | |
| Moss Adams LLP | Adp of the SNF | Jun 1, 2014 | |
| Adp of the SNF | Aug 17, 2017 | ||
| Adp of the SNF | Jul 13, 2025 | ||
| Carrie Vanderzanden | Managing Control - Governing Body | Jun 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Psychiatric/Mental Health Nurse Practitioner
- Windsor, CO
- NPI 1851992176
Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control
-
- Family Medicine Physician
- Salt Lake City, UT
- NPI 1982866679
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 23
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Avamere Rehabilitation of Clackamas
- Skilled Nursing Facility
- Gladstone, OR
- NPI 1518001205
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of Coos Bay
- Skilled Nursing Facility
- Coos Bay, OR
- NPI 1831233519
Avamere Health Services LLC, Avamere Skilled Advisors LLC
-
dba Avamere Crestview of Portland
- Skilled Nursing Facility
- Portland, OR
- NPI 1922046606
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of Eugene
- Skilled Nursing Facility
- Eugene, OR
- NPI 1265576946
Avamere Health Services LLC
-
dba Avamere Rehabilitation of Junction City
- Skilled Nursing Facility
- Junction City, OR
- NPI 1578607164
Avamere Health Services LLC, Avamere Skilled Advisors LLC
-
dba Avamere Court at Keizer
- Skilled Nursing Facility
- Keizer, OR
- NPI 1093732901
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of King City
- Skilled Nursing Facility
- Tigard, OR
- NPI 1295752236
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of Lebanon
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1447277470
Avamere Health Services LLC
-
dba Avamere Rehabilitation of Oregon City
- Skilled Nursing Facility
- Oregon City, OR
- NPI 1780601724
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of Newport
- Skilled Nursing Facility
- Newport, OR
- NPI 1184768772
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Rehabilitation of Hillsboro
- Skilled Nursing Facility
- Hillsboro, OR
- NPI 1346267317
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
-
dba Avamere Riverpark of Eugene
- Skilled Nursing Facility
- Eugene, OR
- NPI 1467490144
Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC
Practitioners & affiliated clinicians
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.
-
- Family Medicine Physician
- Salt Lake City, UT
- NPI 1982866679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390435200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739923200000",
"number": "1699198812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE",
"address_2": "SUITE F",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "503-570-3405",
"fax_number": "503-570-3315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4515 SUNNYSIDE RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973023928",
"telephone_number": "503-370-8284"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNNYSIDE OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-23",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A",
"authorized_official_last_name": "KOFSTAD",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "971-224-2033"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Avamere Transitional Care at Sunnyside",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.