Active NPI
CHP Layton Ut Tenant Corp
- Skilled Nursing Facility
- Layton, UT
National Provider Identifier
1780088385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2015-NCF-UT000437
- Legal business name
- CHP LAYTON UT TENANT CORP
- Doing business as
- Fairfield Village Rehabilition
- Practice address
- 1203 N Fairfield Rd
Layton, UT 84041-8321 - Phone
- (801) 807-0111
- NPI assigned
- Oct 10, 2014
- 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
- Kevin Ray Maddron
- Title
- Senior Vice President
- Phone
- (407) 540-7519
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2015-NCF-UT000437 | UT | Primary |
Addresses
Primary practice location
1203 N Fairfield Rd
Layton, UT 84041-8321
Mailing address
450 S Orange Ave
Orlando, FL 32801-3383
Phone (407) 540-7652
Other names 1
- Fairfield Village Rehabilition
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141218000750 | UT | Part A Provider - Skilled Nursing Facility | 0941523203 | Practice locations: Layton, UT |
Skilled nursing facility certification: CCN 465174
- Legal name
- CHP LAYTON UT TENANT CORP
- Doing business as
- FAIRFIELD VILLAGE REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Dec 2, 2010
- Last certification
- Jan 8, 2025
- Beds
- 40
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Generations, LLC, CHP Layton Tenant Corp
- Most recent change of ownership
- Nov 20, 2014
- Organization structure
- Corporation
- Incorporated
- Oct 1, 2014 in DE
- Enrollment address
- 1205 N Fairfield Rd
Layton, UT 84041-8300 - Nursing home name
- FAIRFIELD VILLAGE REHABILITATION
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Fairfield Village Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 2, 2010
- Medicare certification status
- Active
- Certified beds
- 40
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
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 |
|---|---|---|---|
| CHP TRS Holding Inc | 5% Or Greater Direct Ownership Interest | Oct 1, 2014 | 100% |
| Kristin Paige Walker | Operational/Managerial Control | Jan 15, 2016 | |
| Adp of the SNF | Jan 15, 2016 | ||
| Adp of the SNF | Nov 20, 2014 | ||
| Kevin Detz | Corporate Officer | Mar 11, 2026 | |
| Tabitha Bailey | Corporate Officer | Mar 11, 2026 | |
| Corporate Director | Mar 11, 2026 | ||
| Operational/Managerial Control | Mar 11, 2026 | ||
| SSL Sparti LLC | 5% Or Greater Indirect Ownership Interest | Mar 11, 2026 | |
| Adp of the SNF | Mar 11, 2026 | ||
| Indirect Ownership Interest | Mar 11, 2026 | ||
| Michael L Beus | Operational/Managerial Control | Jul 1, 2015 | |
| Adp of the SNF | Jul 1, 2015 | ||
| Chad Herrick | Operational/Managerial Control | Dec 28, 2022 | |
| Managing Control - Governing Body | Dec 28, 2022 | ||
| Adp of the SNF | Dec 28, 2022 | ||
| Brandon M Ribar | Corporate Officer | Mar 11, 2026 | |
| Corporate Director | Mar 11, 2026 | ||
| Operational/Managerial Control | Mar 11, 2026 | ||
| Jodi L Langhorst | Operational/Managerial Control | Mar 25, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Timothy Cober | Corporate Officer | Mar 11, 2026 | |
| Adp of the SNF | Nov 20, 2014 | ||
| Capital Senior Living Corporation | 5% Or Greater Indirect Ownership Interest | Mar 11, 2026 | |
| Operational/Managerial Control | Mar 11, 2026 | ||
| Adp of the SNF | Mar 11, 2026 | ||
| Indirect Ownership Interest | Mar 11, 2026 | ||
| Kathleen C Levee | Operational/Managerial Control | Aug 1, 2020 | |
| Adp of the SNF | Aug 1, 2020 | ||
| Kristin Elaine Porm | Operational/Managerial Control | Mar 17, 2015 | |
| Managing Control - Governing Body | Mar 17, 2015 | ||
| Adp of the SNF | Mar 17, 2015 | ||
| Generations, L.L.C | Adp of the SNF | Nov 20, 2014 | |
| SSL Sparti Property Holdings Inc. | 5% Or Greater Indirect Ownership Interest | Mar 11, 2026 | |
| Adp of the SNF | Mar 11, 2026 | ||
| Indirect Ownership Interest | Mar 11, 2026 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Layton, UT
- NPI 1770569543
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
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": "1412899200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1439337600000",
"number": "1780088385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328013383",
"telephone_number": "407-540-7652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1203 N FAIRFIELD RD",
"city": "LAYTON",
"state": "UT",
"postal_code": "840418321",
"telephone_number": "801-807-0111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHP LAYTON UT TENANT CORP",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-10",
"last_updated": "2015-08-12",
"status": "A",
"authorized_official_last_name": "MADDRON",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "RAY",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "407-540-7519"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "UT",
"license": "2015-NCF-UT000437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fairfield Village Rehabilition",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.