NPIMap

Organization Active NPI

Maryland Gardens SNF, LLC

  • Skilled Nursing Facility
  • Phoenix, AZ
National Provider Identifier
1831800929
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARYLAND GARDENS SNF, LLC
Practice address
31 W Maryland Ave
Phoenix, AZ 85013-1227
Phone
(602) 265-7484
NPI assigned
Dec 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

31 W Maryland Ave
Phoenix, AZ 85013-1227

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Maryland Gardens Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230807001564 AZ Part A Provider - Skilled Nursing Facility 4284095209 Practice locations: Phoenix, AZ

Skilled nursing facility certification: CCN 035247

Legal name
MARYLAND GARDENS SNF LLC
Doing business as
MARYLAND GARDENS POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 20, 1998
Last certification
Jul 12, 2024
Beds
58
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PACS
Organization structure
LLCProprietary
Enrollment address
31 W Maryland Ave
Phoenix, AZ 85013-1227
Nursing home name
MARYLAND GARDENS POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Maryland Gardens Post AcuteCCN 035247
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 20, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5856.6 residents per day on average
Chain
Pacs Group274 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

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
03D0526658Maryland Gardens Post Acute31 W Maryland Ave, Phoenix, AZ 85013Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Maryland Gardens Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Providence Group Inc Organization, Farmington, UT Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2023 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership InterestPresident, Ceo Mar 1, 2023 50%
John T Mitchell Individual Corporate OfficerVice President, Asst Secretary Mar 1, 2023
Keith Carroll Individual W-2 Managing EmployeeAdministrator Mar 1, 2023
Frederick G Apt Individual Corporate OfficerVice President, Asst Treasurer Mar 1, 2023
Mark D Hancock Individual 5% Or Greater Indirect Ownership InterestVice President, Cfo, Secretary Mar 1, 2023 50%

Facilities with the same owner 80

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

View all 80

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1831800929",
    "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": "31 W MARYLAND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131227",
            "telephone_number": "602-265-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND GARDENS SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Gardens Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maryland Gardens Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.