NPIMap

Organization Active NPI

Lindsay Gardensidence Opco, LLC

Doing business as Lindsay Gardens Nursing & Rehabilitation

  • Skilled Nursing Facility
  • Lindsay, CA
National Provider Identifier
1770644262
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
120000623 Issued in CA
Legal business name
LINDSAY GARDENSIDENCE OPCO, LLC
Doing business as
Lindsay Gardens Nursing & Rehabilitation
Practice address
1011 W Tulare Rd
Lindsay, CA 93247-1471
Phone
(559) 562-0055
NPI assigned
Dec 12, 2006
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Mr. John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 120000623 CA Primary

Addresses

Primary practice location

1011 W Tulare Rd
Lindsay, CA 93247-1471

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other identifiers 1

IdentifierTypeStateIssuer
LTC55663FMedicaidCA

Other names 1

  • Lindsay Gardens Nursing & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140801000097 CA Part A Provider - Skilled Nursing Facility 9436258340 Practice locations: Lindsay, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770644262. Details of each certification follow.

Skilled nursing facility certification: CCN 555663

Legal name
LINDSAY GARDENSIDENCE OPCO, LLC
Doing business as
LINDSAY GARDENS NURSING & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 7, 1996
Last certification
Jul 18, 2024
Beds
99
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS
Organization structure
LLCProprietary
Incorporated
Jul 31, 2014 in CA
Enrollment address
1011 W Tulare Rd
Lindsay, CA 93247-1471
Nursing home name
LINDSAY GARDENS NURSING & REHABILITATION
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lindsay Gardens Nursing & RehabilitationCCN 555663 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 7, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9992.4 residents per day on average
Chain
Pacs Group274 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
05D0930211Lindsay Gardens Nursing & Rehabilitation1011 W Tulare Road, Lindsay, CA 93247Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Riley Bennett Individual W-2 Managing EmployeeAd; Aug 21, 2023
Operational/Managerial ControlAdministrator Aug 21, 2023
Stephen M Grossman Individual Contracted Managing EmployeeMD; Jan 1, 2024
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Providence Group of California LLC Organization, Farmington, UT LLC 5% Or Greater Direct Ownership Interest Jul 31, 2014 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 186

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

View all 186

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 3

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1770644262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W TULARE RD",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932471471",
            "telephone_number": "559-562-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDSAY GARDENSIDENCE OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "120000623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55663F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lindsay Gardens Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lindsay, CA

Sources for this page

Verify at the official NPI Registry.