Beaver Valley Hospital

Organization Active NPI Community Based Hospice Care Agency · Beaver, UT

NPI 1720099229 · NPPES record last updated Apr 24, 2013

Key facts

NPI
1720099229
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
License
2005-HOSPICE-63766 (UT)
Legal business name
BEAVER VALLEY HOSPITAL
Practice address
1109 N 100 West
Beaver, UT 84713-1670
Phone
(435) 438-7100
Fax
(435) 438-7166
NPI assigned
Aug 10, 2006
Organization subpart
No

Authorized official

Name
Mr. Craig Val Davidson
Title
Administrator
Phone
(435) 438-7101

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Facilities with the same owner 9

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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Beaver Valley Hospice CCN 461544
Ownership
Government
Certified
Dec 16, 2004

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Hospice certification: CCN 461544

Legal name
BEAVER VALLEY HOSPITAL
Doing business as
BEAVER VALLEY HOSPITAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 16, 2004
Last certification
Jan 28, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
Government · Non-profit
Enrollment address
1109 N 100 W
Beaver, UT 84713-7746

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Beaver City Corporation
Organization · Beaver, UT
Corporation
5% Or Greater Direct Ownership Interest Jul 1, 1966 100%
Scott a Langford
Individual
Corporate Officer
Administrator
Jul 1, 2017 100%
Tyler Moss
Individual
Corporate Officer
Chief Financial Officer
Jul 1, 2017 100%
W-2 Managing Employee
Cfo
Jul 1, 2017 100%

All facility ownership & control disclosures 32

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Red Cliffs Health and Rehab
St George, UT · CCN 465137
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Sep 18, 2018
Sep 18, 2018
Sandy Health and Rehab
Sandy, UT · CCN 465111
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Feb 1, 2015
Sep 18, 2028
Four Corners Regional Care Center
Blanding, UT · CCN 465057
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2015
Parkdale Health and Rehab
Price, UT · CCN 465102
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Indirect Ownership Interest (100%)
Feb 1, 2015
Sep 18, 2028
Sep 18, 2018
Spring Creek Healthcare Center
Salt Lake City, UT · CCN 465049
Skilled nursing facility Operational/Managerial Control
Direct Ownership Interest (100%)
Sep 18, 2018
Sep 18, 2018
South Ogden Post Acute
Ogden, UT · CCN 465117
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Nov 1, 2015
Aug 29, 2025
Meadowbrook Rehabilitation and Nursing
Salt Lake City, UT · CCN 465158
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Spanish Fork Rehabilitation and Nursing
Spanish Fork, UT · CCN 465183
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Nov 1, 2015
Nov 1, 2015
Millcreek Rehabilitation and Nursing
Salt Lake City, UT · CCN 465185
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Cedar Health and Rehabilitation
Cedar City, UT · CCN 465143
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Bella Terra St George
St George, UT · CCN 465152
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Feb 2, 2016
Feb 2, 2016
City Creek Post Acute
Salt Lake City, UT · CCN 465072
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Hurricane Health and Rehabilitation
Hurricane, UT · CCN 465101
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Orem Rehabilitation and Nursing Center
Orem, UT · CCN 465104
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Paramount Health and Rehabilitation
Salt Lake City, UT · CCN 465100
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Pinnacle Nursing and Rehabilitation Center
Price, UT · CCN 465098
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Provo Rehabilitation and Nursing
Provo, UT · CCN 465119
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Copper Ridge Health Care
West Jordan, UT · CCN 465108
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Draper Rehabilitation and Care Center
Draper, UT · CCN 465091
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
St Joseph Villa
Salt Lake City, UT · CCN 465095
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Mt. Ogden Health and Rehabilitation Center
Washington Terrace, UT · CCN 465069
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Holladay Healthcare Center
Salt Lake City, UT · CCN 465109
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Cascades at Orchard Park
Orem, UT · CCN 465090
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Jul 19, 2016
Sep 18, 2028
St George Rehabilitation
St George, UT · CCN 465064
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2016
Crestwood Rehabilitation and Nursing
Ogden, UT · CCN 465083
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2016
Cascades at Riverwalk
Midvale, UT · CCN 465184
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF
Sep 18, 2018
Jul 1, 2017
Sep 18, 2018
Highland Care Center
Holladay, UT · CCN 465078
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 29, 2017
Heritage Park Healthcare and Rehabilitation
Roy, UT · CCN 465003
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2017
Pointe Meadows Health and Rehabilitation
Lehi, UT · CCN 465188
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 2, 2019
The Terrace Transitional
Ogden, UT · CCN 465115
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2019
Alpine Meadow Rehabilitation and Nursing
West Valley City, UT · CCN 465191
Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Jul 19, 2016
Jul 19, 2016
Monument Healthcare Millcreek
Millcreek, UT · CCN 465139
Skilled nursing facility Operational/Managerial Control Dec 6, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040811000897 UT Part a Provider - Hospice 2769376326 Practice locations: Beaver, UT

National Provider Directory

Tax ID family
B N Robinson MD (82 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2005-HOSPICE-63766 UT Yes

Addresses

Primary practice location

1109 N 100 West
Beaver, UT 84713-1670

Mailing address

PO Box 1670
Beaver, UT 84713-1670
Phone (435) 438-7100

Other providers in Beaver, UT

All providers in Beaver, UT · Community Based Hospice Care Agency in Utah

Sources for this page

Verify at the official NPI Registry.