NPIMap

Organization Active NPI

Tracy Ridge Healthcare, Inc.

  • Skilled Nursing Facility
  • Turlock, CA
National Provider Identifier
1962224592
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TRACY RIDGE HEALTHCARE, INC.
Practice address
1111 E Tuolumne Rd
Turlock, CA 95382-1541
Phone
(209) 632-7577
NPI assigned
Oct 25, 2024
Last updated
Oct 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1111 E Tuolumne Rd
Turlock, CA 95382-1541

Mailing address

1111 E Tuolumne Rd
Turlock, CA 95382-1541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251028004564 CA Part A Provider - Skilled Nursing Facility 6406345602 Practice locations: Turlock, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962224592. Details of each certification follow.

Skilled nursing facility certification: CCN 555240

Legal name
TRACY RIDGE HEALTHCARE, INC.
Doing business as
TURLOCK NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 25, 1986
Last certification
Aug 15, 2024
Beds
144
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Ensign
Organization structure
CorporationProprietary
Enrollment address
1111 E Tuolumne Rd
Turlock, CA 95382-1541
Nursing home name
TURLOCK NURSING AND REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Turlock Nursing and Rehabilitation CenterCCN 555240 · All quality measures
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
Sep 25, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
144133.5 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Ownership change
Changed ownership in the last 12 months

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Flagstone Healthcare North LLC Organization, San Juan Capistrano, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 20, 2024 100%
Barry Port Individual Corporate DirectorSole Manager Flagstone Healthcare N Jul 26, 2018
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Sep 20, 2024 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Sep 20, 2024
Adam Willits Individual Corporate OfficerDirector Tracy Ridge Healthcare Sep 20, 2024
Ami Sato Individual Corporate OfficerTreasurer Tracy Ridge Healthcare Sep 20, 2024
Alexander Y Chan Individual Operational/Managerial Control Aug 1, 2025
Managing Control - Governing BodyMedical Director Aug 1, 2025
Adp of the SNF Aug 1, 2025
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Cory R Monette Individual Corporate OfficerPresident Tracy Ridge Healthcare Sep 20, 2024
Cheryl Rice Individual Operational/Managerial Control Aug 1, 2025
Managing Control - Governing BodyAdministrator Aug 1, 2025
Adp of the SNF Aug 1, 2025
Soon Burnam Individual Corporate OfficerSecretary Tracy Ridge Healthcare Sep 20, 2024

Owners & managing parties with NPI records 1

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

  • Alexander Y Chan, M.D.
    • Internal Medicine Physician
    • Stockton, CA
    • NPI 1386722296

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

    CMS ownership

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

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": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1962224592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E TUOLUMNE RD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953821541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E TUOLUMNE RD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953821541",
            "telephone_number": "209-632-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY RIDGE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.