NPIMap

Organization Active NPI

Southside Healthcare, Inc.

Doing business as Omaha Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Omaha, NE
National Provider Identifier
1942540265
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTHSIDE HEALTHCARE, INC.
Doing business as
Omaha Nursing and Rehabilitation Center
Practice address
4835 S 49TH St
Omaha, NE 68117-2002
Phone
(402) 733-7200
Fax
(402) 733-1736
NPI assigned
Feb 22, 2013
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NE Primary

Addresses

Primary practice location

4835 S 49TH St
Omaha, NE 68117-2002

Mailing address

4835 S 49TH St
Omaha, NE 68117-2002
Phone (402) 733-7200

Other names 1

  • Omaha Nursing and Rehabilitation Center 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 NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130517000543 NE Part A Provider - Skilled Nursing Facility 8921917550 Practice locations: Omaha, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942540265. Details of each certification follow.

Skilled nursing facility certification: CCN 285240

Legal name
SOUTHSIDE HEALTHCARE INC
Doing business as
OMAHA NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 2001
Last certification
Jun 13, 2024
Beds
70
Ownership / control type
Corporation
Multi-facility organization
Gateway Healthcare, Inc.
Organization structure
CorporationProprietary
Enrollment address
4835 S 49TH St
Omaha, NE 68117-2002
Nursing home name
OMAHA NURSING AND REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Omaha Nursing and Rehabilitation CenterCCN 285240 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7057.3 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
2Fines totaling $39,146

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
28D0672360Omaha Nursing and Rehabilitation Center4835 South 49TH Street, Omaha, NE 68117Certificate of waiverAug 31, 2026

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
Onshift Inc Organization, Dallas, TX Corporation Operational/Managerial Control May 1, 2013
Kare Technologies LLC Organization, Houston, TX LLC Operational/Managerial Control May 1, 2013
The Ensign Group Inc Organization, Mission Viejo, CA 5% Or Greater Indirect Ownership Interest Jul 1, 2011 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Apr 1, 2013
Ami Sato Individual Corporate OfficerTreasurer Southside Healthcare Sep 9, 2024
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF May 1, 2013
David Jorgensen Individual Corporate DirectorDirector Southside Healthcare, Inc. Jan 1, 2024
49TH Street Health Holdings LLC Organization, San Clemente, CA LLC Adp of the SNF May 1, 2013
Gateway Healthcare LLC Organization, Mission Viejo, CA LLC 5% Or Greater Direct Ownership Interest Feb 19, 2013 100%
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF May 1, 2013
Douglas a Williams Individual Operational/Managerial ControlAdministrator Jun 3, 2017
Managing Control - Governing BodyAdministrator Jun 3, 2017
Adp of the SNF Aug 5, 2025
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF May 1, 2013
Tara Helenthal Individual Corporate OfficerPresident Southside Healthcare, Inc Sep 9, 2024
Arif a Sattar Individual Operational/Managerial Control Jul 1, 2021
Managing Control - Governing BodyMedical Director Jul 1, 2021
Adp of the SNF Jul 1, 2025
Soon Burnam Individual Corporate OfficerSecretary Southside Healthcare, Inc Feb 19, 2013

Owners & managing parties with NPI records 1

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

  • Arif A Sattar, M.D.
    • Internal Medicine Physician
    • Lincoln, NE
    • NPI 1043253222

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

    CMS ownership

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1942540265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 S 49TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681172002",
            "telephone_number": "402-733-7200",
            "fax_number": "402-733-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 S 49TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681172002",
            "telephone_number": "402-733-7200",
            "fax_number": "402-733-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "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 esMD eMDR",
            "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": "Omaha Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omaha Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.