NPIMap

Organization Active NPI

Regency Gresham Nursing & Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Gresham, OR
National Provider Identifier
1790909786
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
808550 Issued in OR
Legal business name
REGENCY GRESHAM NURSING & REHABILITATION CENTER LLC
Practice address
5905 SE Powell Valley Rd
Gresham, OR 97080-1919
Phone
(503) 665-1151
Fax
(503) 669-1966
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Mr. Marvin B Beddoe
Title
Ceo
Phone
(425) 392-4066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 808550 OR Primary

Addresses

Primary practice location

5905 SE Powell Valley Rd
Gresham, OR 97080-1919

Mailing address

3326 160TH Ave SE
Suite 120
Bellevue, WA 98008-6418
Phone (425) 392-4066

Other identifiers 1

IdentifierTypeStateIssuer
800117MedicaidOR

Other names 1

  • Regency Gresham Nursing & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070509000145 OR Part A Provider - Skilled Nursing Facility 0547366452 Practice locations: Gresham, OR

Skilled nursing facility certification: CCN 385015

Legal name
REGENCY GRESHAM NURSING & REHABILITATION CENTER, LLC
Doing business as
REGENCY GRESHAM NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 1, 1967
Last certification
Jul 1, 2024
Beds
128
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Regency Pacific Management
Organization structure
LLCProprietary
Incorporated
Mar 14, 2007 in WA
Enrollment address
5905 SE Powell Valley Rd
Gresham, OR 97080-1919
Nursing home name
REGENCY GRESHAM NURSING & REHABILITATION CENTER
Affiliated entity
REGENCY PACIFIC MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Regency Gresham Nursing & Rehabilitation CenterCCN 385015
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12890.1 residents per day on average
Chain
Regency Pacific Management27 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
38D0656808Regency Gresham Nursing & Rehab Center5905 SE Powell Valley Rd, Gresham, OR 97080Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

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
Andrew Rapp Individual Operational/Managerial Control Mar 8, 2016
Adp of the SNF Mar 8, 2016
Sarah E Dunham Individual Operational/Managerial Control Sep 1, 2022
Adp of the SNF Sep 1, 2022
Omnicare LLC Organization, Woonsocket, RI LLC, Medical provider/supplier Adp of the SNF Sep 1, 2013
Regency Pacific Management LLC Organization, Bellevue, WA LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Apr 1, 2010 100%
Adp of the SNF Aug 26, 2025
James Lee Clay Individual 5% Or Greater Direct Ownership Interest Apr 23, 2007 33.33%
Adp of the SNF Jul 1, 2007
Anthony Knippers Individual Operational/Managerial Control Jul 16, 2018
Adp of the SNF Jul 16, 2018
Sandra Beddoe Individual Operational/Managerial Control Jun 1, 2001
Adp of the SNF Jun 1, 2001
David P Stroud Individual 5% Or Greater Direct Ownership Interest Apr 23, 2007 33.33%
Adp of the SNF Jul 1, 2007
Marvin B Beddoe Individual 5% Or Greater Direct Ownership InterestCeo Apr 26, 2007 33.33%
Operational/Managerial Control Apr 23, 2007
Adp of the SNF Apr 23, 2007
Organization, Bellevue, WA LLC Adp of the SNF Jul 1, 2007
Organization, Portland, OR Corporation, Consulting firm Adp of the SNF Apr 15, 2025
Organization, Portland, OR LLC, Consulting firm Adp of the SNF Apr 15, 2025

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 19

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

View all 19

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1790909786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 160TH AVE SE",
            "address_2": "SUITE 120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980086418",
            "telephone_number": "425-392-4066",
            "fax_number": "425-623-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801919",
            "telephone_number": "503-665-1151",
            "fax_number": "503-669-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY GRESHAM NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "BEDDOE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-392-4066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": "808550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800117",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Gresham Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.