Organization Active NPI

Sunnyside Operations LLC

Doing business as Avamere Transitional Care at Sunnyside

  • Skilled Nursing Facility
  • Salem, OR
National Provider Identifier
1699198812
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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)CodeLicenseStatePrimary
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 Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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 IDStateProvider typePAC IDDetails
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
LLCProprietary
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 SunnysideCCN 385189 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 24, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8874.8 residents per day on average
Chain
Avamere27 facilities in the chain

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
38D0937509Avamere Transitional Care at Sunnyside4515 Sunnyside Road SE, Salem, OR 97302Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Avamere Skilled Advisors LLC Organization, Wilsonville, OR LLC, For-profit Operational/Managerial Control Jun 1, 2014
Adp of the SNF Jul 14, 2025
Sabra Health Care Reit Inc Organization, Tustin, CA Corporation, Holding company, For-profit, Real estate investment trust (REIT) Adp of the SNF Aug 17, 2017
Michelle Funderberg Individual Managing Control - Governing BodyVoting Member Jan 1, 2025
Adp of the SNF Jan 1, 2025
Karl Rickard Miller Individual Indirect Ownership Interest Jun 1, 2014 100%
Organization, Tustin, CA LLC, For-profit Adp of the SNF Aug 7, 2015
Organization, Spokane Valley, WA Corporation, For-profit Adp of the SNF Jul 13, 2025
Ari Operations, LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2014 100%
Jennifer Dana Individual Operational/Managerial Control May 1, 2022
Adp of the SNF May 1, 2022
Organization, Charlotte, NC LLC, For-profit Adp of the SNF Jul 13, 2025
Diane Vangorder Individual Operational/Managerial Control Dec 1, 2023
Adp of the SNF Dec 1, 2023
Midcap Finco LLC Organization, Bethesda, MD LLC, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest May 30, 2014
Operational/Managerial Control May 30, 2014
Glen Robert Cavallo Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Ariso LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual Direct Ownership Interest Jun 1, 2014 100%
Michael Seifert Individual Operational/Managerial Control Apr 14, 2025
Adp of the SNF Jun 1, 2026
Carolyn Staples Individual Managing Control - Governing BodyVoting Member Oct 1, 2025
Adp of the SNF Oct 1, 2025
Karl Rickard Miller Jr Revocable Trust Organization, Ketchum, ID Indirect Ownership Interest Jun 1, 2014 100%
Avamere Health Services LLC Organization, Wilsonville, OR For-profit, Chain home office Operational/Managerial Control Jun 1, 2014
Adp of the SNF Jul 13, 2025
Snapmedtech,Inc. Organization, Atlanta, GA Corporation, Medical staffing company, For-profit Adp of the SNF Sep 8, 2025
Organization, Tustin, CA Corporation, Holding company, For-profit, Real estate investment trust (REIT) Adp of the SNF Aug 17, 2017
Todd Inskeep Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Jan 21, 2022
Consolidated Billing Services Inc Organization, Spokane Valley, WA Corporation, For-profit Adp of the SNF Jun 1, 2014
Roberto Garcia Individual Operational/Managerial Control Feb 1, 2026
Managing Control - Governing BodyVoting Member Feb 1, 2026
Adp of the SNF Feb 1, 2026
Colby Strunk Individual Managing Control - Governing BodyNon-Voting Member Jun 1, 2025
Adp of the SNF Sep 6, 2022
Loriel Fanunal Individual Operational/Managerial Control Jan 2, 2023
Adp of the SNF Jan 2, 2023
Shannon Becerra Individual Adp of the SNF Feb 1, 2025
Dustin J. Gibbins Individual Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 1, 2025
Kim Games Individual Adp of the SNF Aug 15, 2024
Rande Holdings, LLC Organization, Wilsonville, OR LLC, For-profit Adp of the SNF Jun 1, 2024
Avamere Group LLC Organization, Wilsonville, OR LLC, Holding company, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2014 100%
Tonia Hoskins Individual Operational/Managerial Control Jul 19, 2024
Adp of the SNF Jun 1, 2025
Mary Kofstad Individual Operational/Managerial Control Feb 13, 2024
Managing Control - Governing BodyVoting Member Jun 1, 2025
Sabra Health Care Limited Partnership Organization, Tustin, CA Holding company, For-profit Adp of the SNF Aug 17, 2017
Yolanda Presley Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Nathan M Ruden Individual Operational/Managerial Control Sep 1, 2023
Adp of the SNF Jun 1, 2023
Incovate Solutions, LLC Organization, Charlotte, NC LLC, For-profit Adp of the SNF Jan 21, 2022
Organization, Tustin, CA LLC, Holding company, For-profit Adp of the SNF Aug 17, 2017
Cody Feakin Individual Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 1, 2025
Organization, Wilsonville, OR LLC, For-profit Adp of the SNF Jul 13, 2025
Misty Dawn Reid Individual Operational/Managerial Control Jan 2, 2025
Managing Control - Governing BodyVoting Member Jun 1, 2025
Adp of the SNF Jan 2, 2025
Debra Scott Individual Adp of the SNF Aug 1, 2025
Sabra Health Care, LLC Organization, Tustin, CA LLC, Holding company, For-profit Adp of the SNF Aug 17, 2017
Moss Adams LLP Organization, Seattle, WA For-profit Adp of the SNF Jun 1, 2014
Organization, Tustin, CA Holding company, For-profit Adp of the SNF Aug 17, 2017
Organization, Seattle, WA For-profit Adp of the SNF Jul 13, 2025
Carrie Vanderzanden Individual Managing Control - Governing BodyVoting Member 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.

Facilities with the same owner 23

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

View all 23

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.

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

Verify at the official NPI Registry.