NPIMap

Organization Active NPI

Puyallup Care Center, Inc

Doing business as Regency at Puyallup Rehabilitation Center

  • Skilled Nursing Facility
  • Puyallup, WA
National Provider Identifier
1699760025
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH1376 Issued in WA
Legal business name
PUYALLUP CARE CENTER, INC
Doing business as
Regency at Puyallup Rehabilitation Center
Practice address
516 23Rd Ave SE
Puyallup, WA 98372-4659
Phone
(253) 845-6631
Fax
(253) 848-1357
NPI assigned
Sep 12, 2005
Last updated
Mar 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Mr. Gregory J Vislocky
Title
Ex VP of Finance / Partner
Phone
(360) 735-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH1376 WA Primary

Addresses

Primary practice location

516 23Rd Ave SE
Puyallup, WA 98372-4659

Mailing address

516 23Rd Ave SE
Puyallup, WA 98372-4659
Phone (253) 845-6631

Other identifiers 2

IdentifierTypeStateIssuer
4113767MedicaidWA
4114344MedicaidWA

Other names 1

  • Regency at Puyallup Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000946 WA Part A Provider - Skilled Nursing Facility 6608834973 Practice locations: Puyallup, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699760025. Details of each certification follow.

Skilled nursing facility certification: CCN 505211

Legal name
PUYALLUP CARE CENTER, INC
Doing business as
PUYALLUP NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 31, 1971
Last certification
Aug 16, 2024
Beds
96
Ownership / control type
Corporation
Multi-facility organization
Nightingale Healthcare
Organization structure
CorporationProprietary
Incorporated
Nov 7, 2003 in WA
Enrollment address
516 23Rd Ave SE
Puyallup, WA 98372-4659
Nursing home name
PUYALLUP POST ACUTE
Affiliated entity
REGENCY PACIFIC MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Puyallup Post AcuteCCN 505211 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 31, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9691.0 residents per day on average
Chain
Regency Pacific Management27 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Paul Redhead Individual 5% Or Greater Direct Ownership Interest Nov 7, 2003 33.33%
Corporate OfficerVice President Nov 1, 2012 33.33%
Jennifer Mack Individual W-2 Managing EmployeeOperations Jan 2, 2019 100%
Patsy Hand Individual 5% Or Greater Direct Ownership InterestOfficer Jan 1, 2022 33.33%
James Lee Clay Individual 5% Or Greater Direct Ownership Interest Nov 7, 2003 33.33%
Corporate OfficerPresident Nov 1, 2012 33.33%

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 1

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": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1699760025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 23RD AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724659",
            "telephone_number": "253-845-6631",
            "fax_number": "253-848-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 23RD AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724659",
            "telephone_number": "253-845-6631",
            "fax_number": "253-848-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUYALLUP CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EX VP OF FINANCE / PARTNER",
        "authorized_official_telephone_number": "360-735-7155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113767",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114344",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "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",
            "address_2": "SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Regency at Puyallup Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.