NPIMap

Organization Active NPI

Walnut Creek Community Healthcare, LLC

Doing business as Rossmoor Post Acute

  • Skilled Nursing Facility
  • Walnut Creek, CA
National Provider Identifier
1932801727
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WALNUT CREEK COMMUNITY HEALTHCARE, LLC
Doing business as
Rossmoor Post Acute
Practice address
1226 Rossmoor Pkwy
Walnut Creek, CA 94595-2538
Phone
(925) 975-5000
NPI assigned
Mar 17, 2023
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 NU Primary

Addresses

Primary practice location

1226 Rossmoor Pkwy
Walnut Creek, CA 94595-2538

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Rossmoor Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604003616 CA Part A Provider - Skilled Nursing Facility 8527500628 Practice locations: Walnut Creek, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932801727. Details of each certification follow.

Skilled nursing facility certification: CCN 555446

Legal name
WALNUT CREEK COMMUNITY HEALTHCARE LLC
Doing business as
ROSSMOOR POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 9, 1991
Last certification
Feb 13, 2025
Beds
155
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Providence Group NH, LLC
Most recent change of ownership
May 4, 2023
Organization structure
LLCProprietary
Incorporated
Mar 10, 2023 in CA
Enrollment address
1226 Rossmoor Parkway
Walnut Creek, CA 94595-2538
Nursing home name
ROSSMOOR POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rossmoor Post AcuteCCN 555446 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 9, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
155148.9 residents per day on average
Chain
Pacs Group274 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
05D0673565Rossmoor Post Acute1226 Rossmoor Parkway, Walnut Creek, CA 94595Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Mar 10, 2023 35.2%
John T Mitchell Individual 5% Or Greater Indirect Ownership InterestSecretary Feb 1, 2024
Operational/Managerial Control Jan 1, 2024
Zahid I Shaikh Individual Operational/Managerial Control Feb 14, 2024
Adp of the SNF Feb 14, 2024
Melissa Djaffer Individual Operational/Managerial Control Mar 11, 2024
Adp of the SNF Mar 11, 2024
Organization, Suffern, NY LLC Adp of the SNF Jul 28, 2023
Steven Michael Stock Individual Operational/Managerial Control Jun 16, 2025
Adp of the SNF Jun 16, 2025
Truist Bank Organization, Farmington, UT Financial institution 5% Or Greater Security Interest Dec 7, 2023 100%
Frederick G Apt Individual 5% Or Greater Indirect Ownership InterestManager, Treasurer Feb 1, 2024
Operational/Managerial Control Jan 1, 2024
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm Operational/Managerial Control Feb 1, 2024
Adp of the SNF Feb 1, 2024
Joshua O Jergensen Individual 5% Or Greater Indirect Ownership InterestManager, President Feb 1, 2026
Operational/Managerial Control Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Mar 10, 2023 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 186

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

View all 186

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": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1932801727",
    "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": "1226 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952538",
            "telephone_number": "925-975-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK COMMUNITY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rossmoor Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rossmoor Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.