Organization Active NPI

Peoria Healthcare LLC

  • Skilled Nursing Facility
  • Peoria, AZ
National Provider Identifier
1831697168
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PEORIA HEALTHCARE LLC
Practice address
13215 N 94TH Dr
Peoria, AZ 85381-4838
Phone
(623) 933-7722
Fax
(623) 933-9796
NPI assigned
Feb 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

13215 N 94TH Dr
Peoria, AZ 85381-4838

Mailing address

13215 N 94TH Dr
Peoria, AZ 85381-4838
Phone (623) 933-7722

Other names 1

  • Peoria Post Acute and Rehabilitation 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 AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180413001248 AZ Part A Provider - Skilled Nursing Facility 0244593788 Practice locations: Peoria, AZ

Skilled nursing facility certification: CCN 035144

Legal name
PEORIA HEALTHCARE LLC
Doing business as
PEORIA POST ACUTE AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 10, 1987
Last certification
Apr 5, 2024
Beds
179
Ownership / control type
Partnership
Multi-facility organization
Bandera Healthcare
Organization structure
CorporationProprietary
Enrollment address
13215 N 94TH Dr
Peoria, AZ 85381-4838
Nursing home name
PEORIA POST ACUTE AND REHABILITATION
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Peoria Post Acute and RehabilitationCCN 035144
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Jun 10, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
179170.5 residents per day on average
Chain
The Ensign Group342 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
03D0531694Peoria Post Acute and Rehabilitation13215 N 94TH Dr, Peoria, AZ 85381ComplianceMar 8, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Standard Bearer Healthcare Op LP Organization, San Juan Capistrano, CA Adp of the SNF Jan 1, 2022
Christine Jones Individual Corporate OfficerSole Manager Peoria Healthcare LLC Jan 1, 2026
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation, For-profit Adp of the SNF Jan 1, 2022
Indirect Ownership Interest Sep 25, 2006 100%
Bandera Healthcare LLC Organization, San Juan Capistrano, CA LLC, For-profit Direct Ownership Interest Jan 31, 2018 100%
Patrick Salvatore Sciara Individual Operational/Managerial Control Apr 1, 2018
Managing Control - Governing BodyMedical Director Apr 1, 2018
Adp of the SNF Jul 5, 2025
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Grand Avenue Health Holdings LLC Organization, San Juan Capistrano, CA LLC, For-profit Adp of the SNF Jan 1, 2022
Matthew Llewellyn Individual Operational/Managerial Control Feb 1, 2026
Managing Control - Governing BodyAdministrator Feb 1, 2026
Adp of the SNF Feb 1, 2026
Soon Burnam Individual Corporate OfficerSecretary of Peoria Healthcare LLC Jan 31, 2018
Managing Control - Governing BodySecretary of Peoria Healthcare LLC Jan 31, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1831697168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13215 N 94TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814838",
            "telephone_number": "623-933-7722",
            "fax_number": "623-933-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13215 N 94TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814838",
            "telephone_number": "623-933-7722",
            "fax_number": "623-933-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "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",
            "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": "Peoria Post Acute and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peoria Post Acute and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.