Active NPI
Blooming Oaks Wellness & Rehabilitation LLC
- Skilled Nursing Facility
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- BLOOMING OAKS WELLNESS & REHABILITATION LLC
- Practice address
- 9350 Green Park Rd
Saint Louis, MO 63123-7211 - Phone
- (314) 845-0900
- Fax
- (314) 845-0901
- NPI assigned
- Apr 10, 2024
- 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
- David Garetz
- Title
- Cfo
- Phone
- (323) 987-5954
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
9350 Green Park Rd
Saint Louis, MO 63123-7211
Mailing address
9350 Green Park Rd
Saint Louis, MO 63123-7211
Phone (314) 845-0900
Other names 1
- Bluebird Wellness & Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241031000487 | MO | Part A Provider - Skilled Nursing Facility | 9537692447 | Practice locations: Saint Louis, MO |
Skilled nursing facility certification: CCN 265703
- Legal name
- BLOOMING OAKS WELLNESS & REHABILITATION LLC
- Doing business as
- BLUEBIRD WELLNESS AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 21, 2000
- Last certification
- Feb 13, 2024
- Beds
- 188
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- OPCP
- Organization structure
- LLC
- Enrollment address
- 9350 Green Park Rd
Saint Louis, MO 63123-7211 - Nursing home name
- BLUEBIRD WELLNESS AND REHABILITATION
- Affiliated entity
- OPCO SKILLED MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bluebird Wellness and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 21, 2000
- Medicare certification status
- Active
- Certified beds
- 188
- Chain
- Opco Skilled Management
- Penalties (3 years)
- 2
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 |
|---|---|---|---|
| 26D0952543 | Bluebird Wellness and Rehabilitation | Certificate of waiver | Jul 27, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 20
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 |
|---|---|---|---|
| Sesame Realty Trust | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 22% |
| Adp of the SNF | Oct 31, 2024 | ||
| Blooming Willow Partners LLC | 5% Or Greater Indirect Ownership Interest | Jul 30, 2024 | 97% |
| Harold Lutz | Operational/Managerial Control | Jul 30, 2024 | |
| Adp of the SNF | Jul 30, 2024 | ||
| Knobel Realty Trust | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 20% |
| Adp of the SNF | Oct 31, 2024 | ||
| Iqbal I Amin | Operational/Managerial Control | Jul 30, 2024 | |
| Adp of the SNF | Jul 30, 2024 | ||
| Pas B Sol Trust | 5% Or Greater Indirect Ownership Interest | Jul 30, 2024 | 34.15% |
| 9350 Green Park Road Mo LLC | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 100% |
| Adp of the SNF | Oct 31, 2024 | ||
| Derhoben Trust | 5% Or Greater Indirect Ownership Interest | Jul 30, 2024 | 63.42% |
| Willowbrook Investors LLC | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 100% |
| Adp of the SNF | Oct 31, 2024 | ||
| Adam Mindle | 5% Or Greater Mortgage Interest | Jul 30, 2024 | |
| Mordechai Kaplan | 5% Or Greater Mortgage Interest | Jul 30, 2024 | |
| Niv Davidovich | 5% Or Greater Indirect Ownership Interest | Jul 30, 2024 | |
| Brook Partners LLC | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 97% |
| Adp of the SNF | Oct 31, 2024 | ||
| Elizabeth Hagins | 5% Or Greater Mortgage Interest | Jul 30, 2024 | |
| Linz Trust | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 34.15% |
| Adp of the SNF | Oct 31, 2024 | ||
| Jennifer Sternshein | 5% Or Greater Indirect Ownership Interest | Jul 30, 2024 | |
| David Garetz | Operational/Managerial Control | Jul 30, 2024 | |
| Adp of the SNF | Jul 30, 2024 | ||
| Indirect Ownership Interest | Jul 30, 2024 | 2% | |
| Rembrandt Realty Trust | 5% Or Greater Mortgage Interest | Jul 30, 2024 | 21.42% |
| Adp of the SNF | Oct 31, 2024 | ||
| Wildflower Healthcare LLC | 5% Or Greater Direct Ownership Interest | Jul 30, 2024 | 100% |
| Caroline Zimmerman | 5% Or Greater Mortgage Interest | Jul 30, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
- NPI 1184619835
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Blue Springs, MO
- NPI 1639998479
Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC
-
- Skilled Nursing Facility
- Fenton, MO
- NPI 1861231698
Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC
-
- Skilled Nursing Facility
- Saint Louis, MO
- NPI 1427897255
Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC
-
- Skilled Nursing Facility
- Florissant, MO
- NPI 1780437517
Blooming Willow Partners LLC, Derhoben Trust, Pas B Sol Trust, Wildflower Healthcare LLC
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
- NPI 1184619835
-
- Geriatric Medicine (Internal Medicine) Physician
- St Louis, MO
- NPI 1023026804
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
- NPI 1184619835
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- St Louis, MO
- NPI 1023026804
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738540800000",
"number": "1699528422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9350 GREEN PARK RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631237211",
"telephone_number": "314-845-0900",
"fax_number": "314-845-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9350 GREEN PARK RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631237211",
"telephone_number": "314-845-0900",
"fax_number": "314-845-0901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLOOMING OAKS WELLNESS & REHABILITATION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-10",
"last_updated": "2025-02-03",
"certification_date": "2025-02-03",
"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": "Bluebird Wellness & Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.