NPIMap

Organization Active NPI

Beaver Valley Hospital

Doing business as City Creek Post Acute

  • Skilled Nursing Facility
  • Salt Lake City, UT
National Provider Identifier
1770036790
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BEAVER VALLEY HOSPITAL
Doing business as
City Creek Post Acute
Practice address
165 S 1000 E
Salt Lake City, UT 84102-1402
Phone
(801) 322-5521
Fax
(801) 322-0934
NPI assigned
Jul 26, 2016
Last updated
Mar 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X UT Primary

Addresses

Primary practice location

165 S 1000 E
Salt Lake City, UT 84102-1402

Mailing address

165 S 1000 E
Salt Lake City, UT 84102-1402
Phone (801) 322-5521

Other names 1

  • City Creek Post Acute Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160915001435 UT Part A Provider - Skilled Nursing Facility 2769376326 Practice locations: Salt Lake City, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770036790. Details of each certification follow.

Skilled nursing facility certification: CCN 465072

Legal name
BEAVER VALLEY HOSPITAL
Doing business as
CITY CREEK POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 15, 1979
Last certification
Jan 29, 2024
Beds
108
Ownership / control type
Partnership
Organization structure
OtherNon-profit
Incorporated
Aug 1, 1966 in UT
Enrollment address
165 S 1000 E
Salt Lake City, UT 84102-1402
Nursing home name
CITY CREEK POST ACUTE
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
City Creek Post AcuteCCN 465072 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Dec 15, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10869.0 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Parowan Medical Clinic82 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

165 S 1000 E
Slc, UT 84102
Phone (801) 322-5521

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Avenues Healthcare, Inc. Organization, Salt Lake City, UT Corporation Operational/Managerial Control May 1, 2016
Adp of the SNF Sep 15, 2025
Beaver Valley Hospital Organization, Beaver, UT 5% Or Greater Direct Ownership Interest May 1, 2016 100%
KC Ellis Individual Operational/Managerial ControlAdministrator Mar 1, 2016
Managing Control - Governing BodyAdministrator Mar 1, 2016
Adp of the SNF Mar 1, 2016
David H Workman Individual Operational/Managerial Control Sep 20, 2024
Managing Control - Governing BodyMedical Director Sep 20, 2024
Adp of the SNF Sep 20, 2024
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Sep 1, 2006
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Aug 28, 2014
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Sep 1, 2006
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Sep 1, 2006
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Tenth East Holdings LLC Organization, San Clemente, CA LLC Adp of the SNF Aug 28, 2014
Tyler Moss Individual Corporate OfficerCfo Beaver Valley Hospital May 1, 2016
Soon Burnam Individual Corporate OfficerSecretary of Management Company May 1, 2016

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 31

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

FacilityTypeRoleSince
Red Cliffs Health and RehabSt 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 RehabSandy, 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 CenterBlanding, UT, CCN 465057 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2015
Parkdale Health and RehabPrice, 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 CenterSalt Lake City, UT, CCN 465049 Skilled nursing facility Operational/Managerial Control
Direct Ownership Interest (100%)		 Sep 18, 2018
Sep 18, 2018
South Ogden Post AcuteOgden, 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 NursingSalt Lake City, UT, CCN 465158 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Spanish Fork Rehabilitation and NursingSpanish 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 NursingSalt Lake City, UT, CCN 465185 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2015
Cedar Health and RehabilitationCedar City, UT, CCN 465143 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2019
Bella Terra St GeorgeSt George, UT, CCN 465152 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Feb 2, 2016
Feb 2, 2016
Hurricane Health and RehabilitationHurricane, UT, CCN 465101 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Orem Rehabilitation and Nursing CenterOrem, UT, CCN 465104 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Paramount Health and RehabilitationSalt Lake City, UT, CCN 465100 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Pinnacle Nursing and Rehabilitation CenterPrice, UT, CCN 465098 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Provo Rehabilitation and NursingProvo, UT, CCN 465119 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Copper Ridge Health CareWest Jordan, UT, CCN 465108 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Draper Rehabilitation and Care CenterDraper, UT, CCN 465091 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
St Joseph VillaSalt Lake City, UT, CCN 465095 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Mt. Ogden Health and Rehabilitation CenterWashington Terrace, UT, CCN 465069 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Holladay Healthcare CenterSalt Lake City, UT, CCN 465109 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Cascades at Orchard ParkOrem, 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 RehabilitationSt George, UT, CCN 465064 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2016
Crestwood Rehabilitation and NursingOgden, UT, CCN 465083 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2016
Cascades at RiverwalkMidvale, 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 CenterHolladay, UT, CCN 465078 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 29, 2017
Heritage Park Healthcare and RehabilitationRoy, UT, CCN 465003 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2017
Pointe Meadows Health and RehabilitationLehi, UT, CCN 465188 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 2, 2019
The Terrace TransitionalOgden, UT, CCN 465115 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2019
Alpine Meadow Rehabilitation and NursingWest 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 MillcreekMillcreek, UT, CCN 465139 Skilled nursing facility Operational/Managerial Control Dec 6, 2024

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 1

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 2

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": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1770036790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S 1000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021402",
            "telephone_number": "801-322-5521",
            "fax_number": "801-322-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S 1000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021402",
            "telephone_number": "801-322-5521",
            "fax_number": "801-322-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER VALLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "City Creek Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City Creek Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.