Active NPI
SNF Ammon Operating Company LLC.
- Skilled Nursing Facility
- Ammon, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 14, 2010
- Medicare certification status
- Active
- Certified beds
- 50
- Chain
- Promontory Healthcare Management
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 |
|---|---|---|---|
| 13D2006945 | Promontory Point Rehabilitation | Certificate of waiver | May 4, 2028 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| BV SNF Ammon Oc LLC | Direct Ownership Interest | Oct 22, 2009 | 36% |
| Scott Taylor | Operational/Managerial Control | Jun 1, 2017 | |
| Adp of the SNF | May 7, 2025 | ||
| Promontory Healthcare Management LLC | Adp of the SNF | Nov 28, 2025 | |
| BV Operations LLC. | Adp of the SNF | Feb 10, 2015 | |
| SNF Ammon Real Estate LLC | 5% Or Greater Mortgage Interest | Oct 22, 2009 | 100% |
| Adp of the SNF | Oct 22, 2009 | ||
| MVH SNF Holding LLC | Direct Ownership Interest | Oct 22, 2009 | 24% |
| Tcu Management Company LLC. | Direct Ownership Interest | Oct 22, 2009 | 40% |
| Casey Kemmerer | Operational/Managerial Control | Jan 2, 2022 | |
| Adp of the SNF | Apr 23, 2025 | ||
| Anna J Haynes | 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.
-
- Internal Medicine Physician
- Idaho Falls, ID
- NPI 1861542326
Adp of the SNF, Operational/Managerial Control
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.