NPIMap

Organization Active NPI

Woodside SNF Healthcare LLC

Doing business as Woodside Post Acute

  • Skilled Nursing Facility
  • Molalla, OR
National Provider Identifier
1891544631
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WOODSIDE SNF HEALTHCARE LLC
Doing business as
Woodside Post Acute
Practice address
301 Ridings Ave
Molalla, OR 97038-9201
Phone
(503) 829-5591
NPI assigned
May 15, 2024
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 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
(801) 447-9829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

301 Ridings Ave
Molalla, OR 97038-9201

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Woodside Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240826001468 OR Part A Provider - Skilled Nursing Facility 5092254847 Practice locations: Molalla, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891544631. Details of each certification follow.

Skilled nursing facility certification: CCN 385150

Legal name
WOODSIDE SNF HEALTHCARE LLC
Doing business as
WOODSIDE POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 20, 1981
Last certification
May 9, 2025
Beds
92
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Sep 1, 2024
Organization structure
LLCProprietary
Incorporated
May 10, 2024 in OR
Enrollment address
301 Ridings Ave
Molalla, OR 97038-9201
Nursing home name
WOODSIDE POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Woodside Post AcuteCCN 385150 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 20, 1981
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9278.3 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
5Fines totaling $115,888

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
38D0622162Woodside Post Acute301 Ridings Ave, Molalla, OR 97038Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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, Consulting firm, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest May 10, 2024 35.2%
John T Mitchell Individual Operational/Managerial Control May 10, 2024
Molalla 301 Realty LLC Organization, New York, NY LLC, For-profit Adp of the SNF Sep 1, 2024
Amanda Collins Individual Operational/Managerial Control Sep 1, 2024
Frederick G Apt Individual Operational/Managerial Control May 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 10, 2024 100%
Luke May Individual Operational/Managerial Control Sep 1, 2024
Adp of the SNF May 30, 2025
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 10, 2024 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm, For-profit Adp of the SNF Sep 1, 2024
Truist Bank Organization, Charlotte, NC Corporation, Financial institution, For-profit 5% Or Greater Security Interest Sep 1, 2024 100%
Joshua O Jergensen Individual Operational/Managerial Control May 10, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 10, 2024 100%
Christopher R Morris Individual Operational/Managerial Control Sep 1, 2024
Adp of the SNF May 30, 2025
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest May 10, 2024 35.2%

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 265

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

View all 265

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": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1891544631",
    "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": "301 RIDINGS AVE",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970389201",
            "telephone_number": "503-829-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE SNF HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "801-447-9829"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodside Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Molalla, OR

Sources for this page

Verify at the official NPI Registry.