Coos Bay Rehabilitation, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COOS BAY REHABILITATION, LLC

Practice address

2625 Koos Bay Blvd
Coos Bay, OR 97420-4907

Phone

(541) 267-2161

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Mary E. Kofstad

Title

Ceo

Phone

(971) 224-2033

Specialties & licenses 1

Addresses

Other names 1

• Avamere Rehabilitation of Coos Bay Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Skilled nursing facility certification: CCN 385239

Legal name

COOS BAY REHABILITATION, LLC

Doing business as

AVAMERE REHABILITATION OF COOS BAY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 25, 1994

Last certification

May 3, 2024

Beds

92

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Ariso, LLC.

Organization structure

LLCProprietary

Enrollment address

2625 Koos Bay Blvd
Coos Bay, OR 97420-4907

Nursing home name

AVAMERE REHABILITATION OF COOS BAY

Affiliated entity

AVAMERE

Listed as

Avamere Rehabilitation of Coos BayCCN 385239

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 25, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9255.0 residents per day on average

Chain

Avamere27 facilities in the chain

Penalties (3 years)

1Fines totaling $15,593

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 44

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

Owners & managing parties with NPI records 2

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

• Kirsten Marie Winn Carr, M.D.

  • Family Medicine Physician
  • Portland, OR
  • NPI 1225054646

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Misty Reid, AGACNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor, CO
  • NPI 1851992176

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 22

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

• Clackamas Rehabilitation, LLC

  • Skilled Nursing Facility
  • Gladstone, OR
  • NPI 1518001205

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Crestview Operations, LLC

  • Skilled Nursing Facility
  • Portland, OR
  • NPI 1922046606

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Eugene Rehabilitation, LLC

  • Skilled Nursing Facility
  • Eugene, OR
  • NPI 1265576946

  Avamere Health Services LLC

  CMS ownership
• Junction City Rehabilitation, LLC

  • Skilled Nursing Facility
  • Junction City, OR
  • NPI 1578607164

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Keizer Campus Operations, LLC

  • Skilled Nursing Facility
  • Keizer, OR
  • NPI 1093732901

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• King City Rehab, LLC

  • Skilled Nursing Facility
  • Tigard, OR
  • NPI 1295752236

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Lebanon Care Center, LLC

  • Skilled Nursing Facility
  • Lebanon, OR
  • NPI 1447277470

  Avamere Health Services LLC

  CMS ownership
• Mountain View Rehab, LLC

  • Skilled Nursing Facility
  • Oregon City, OR
  • NPI 1780601724

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Newport Rehabilitation, LLC

  • Skilled Nursing Facility
  • Newport, OR
  • NPI 1184768772

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Peckham-Miller, Inc

  • Skilled Nursing Facility
  • Hillsboro, OR
  • NPI 1346267317

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Riverpark Operations, LLC

  • Skilled Nursing Facility
  • Eugene, OR
  • NPI 1467490144

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Sunnyside Operations LLC

  • Skilled Nursing Facility
  • Salem, OR
  • NPI 1699198812

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jonathon Lex Park, MD

  • Family Medicine Physician
  • Bandon, OR
  • NPI 1588649289

  Nursing home

  Care Compare affiliation
• Rajesh Ravuri, MD

  • Internal Medicine Physician
  • Coos Bay, OR
  • NPI 1952386112

  Nursing home

  Care Compare affiliation
• Bhargavbhai Kantibhai Patel, M.D.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1134382328

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1831233519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 KOOS BAY BLVD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204907",
            "telephone_number": "541-267-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOS BAY REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "KOFSTAD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "971-224-2033"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Avamere Rehabilitation of Coos Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Confederated Tribes of Coos, Lower Umpqua, & Siuslaw Indians
• Bret Alan Cook, MD
• Tyler Dawn Cooper, PMHNP
• Coos Bay of Cascadia, LLC
• Coos Bay Rehabilitation, Inc.
• Coos Bay School District 9
• Coos Bay Vision Center, Inc
• Coos Bay Vision Center, LLC
• Coos Clinic LLC
• Coos County Oregon

• Skilled Nursing Facility in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.

Verify at the official NPI Registry.