Organization Active NPI

SNF Ammon Operating Company LLC.

  • Skilled Nursing Facility
  • Ammon, ID
National Provider Identifier
1760719934
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SNF AMMON OPERATING COMPANY LLC.
Practice address
3909 South 25TH East
Ammon, ID 83406
Phone
(208) 528-4000
Fax
(208) 557-2702
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Mr. Sam Long, LHCA
Title
Administrator
Phone
(208) 520-6929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3909 South 25TH East
Ammon, ID 83406

Mailing address

2325 Coronado St
Idaho Falls, ID 83404-7407

Other names 1

  • Promontory Point Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100511000909 ID Part A Provider - Skilled Nursing Facility 0446388557 Practice locations: Idaho Falls, ID

Skilled nursing facility certification: CCN 135137

Legal name
SNF AMMON OPERATING COMPANY LLC.
Doing business as
PROMONTORY POINT REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Oct 14, 2010
Last certification
Feb 12, 2025
Beds
50
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Oct 29, 2009 in ID
Enrollment address
3909 S 25TH E
Idaho Falls, ID 83404-4972
Nursing home name
PROMONTORY POINT REHABILITATION
Affiliated entity
PROMONTORY HEALTHCARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Promontory Point RehabilitationCCN 135137
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Oct 14, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5037.5 residents per day on average
Chain
Promontory Healthcare Management2 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
13D2006945Promontory Point Rehabilitation3909 S 25TH E, Ammon, ID 83406Certificate of waiverMay 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
BV SNF Ammon Oc LLC Organization, Portland, OR LLC, Owned by another organization or individual Direct Ownership Interest Oct 22, 2009 36%
Scott Taylor Individual Operational/Managerial Control Jun 1, 2017
Adp of the SNF May 7, 2025
Promontory Healthcare Management LLC Organization, Portland, OR LLC, Chain home office Adp of the SNF Nov 28, 2025
BV Operations LLC. Organization, Idaho Falls, ID LLC Adp of the SNF Feb 10, 2015
SNF Ammon Real Estate LLC Organization, Idaho Falls, ID Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Oct 22, 2009 100%
Adp of the SNF Oct 22, 2009
MVH SNF Holding LLC Organization, Idaho Falls, ID LLC, Owned by another organization or individual Direct Ownership Interest Oct 22, 2009 24%
Tcu Management Company LLC. Organization, Portland, OR LLC, Owned by another organization or individual Direct Ownership Interest Oct 22, 2009 40%
Casey Kemmerer Individual Operational/Managerial Control Jan 2, 2022
Adp of the SNF Apr 23, 2025
Anna J Haynes Individual Corporate Officer Jan 1, 2019 10%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

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": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1760719934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 SOUTH 25TH EAST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-528-4000",
            "fax_number": "208-557-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNF AMMON OPERATING COMPANY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-520-6929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LHCA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promontory Point Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.