Beaver Valley Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BEAVER VALLEY HOSPITAL

Doing business as

Holladay Healthcare Center

Practice address

4782 S Holladay Blvd
Salt Lake City, UT 84117-5444

Phone

(801) 277-7002

Fax

(801) 272-0622

NPI assigned

Aug 3, 2016

Last updated

Mar 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Treasurer of Management Company

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other names 1

• Holladay Healthcare Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962955237. Details of each certification follow.

• CCN 465109 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 465109

Legal name

BEAVER VALLEY HOSPITAL

Doing business as

HOLLADAY HEALTHCARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 13, 1987

Last certification

Mar 24, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Ensign Facility Services

Most recent change of ownership

May 1, 2016

Organization structure

GovernmentProprietary

Incorporated

Aug 1, 1966 in UT

Enrollment address

4782 S Holladay Blvd
Salt Lake City, UT 84117-5444

Nursing home name

HOLLADAY HEALTHCARE CENTER

Affiliated entity

THE ENSIGN GROUP

Listed as

Holladay Healthcare CenterCCN 465109 · 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

Feb 13, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12079.7 residents per day on average

Chain

The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Beaver Valley Hospital

  • Skilled Nursing Facility
  • St George, UT
  • NPI 1164881025

  Member Of

  NPD member

All disclosed owners & managing parties 12

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

Owners & managing parties with NPI records 1

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

• David H Workman IX, MD

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1659329449

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 31

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facilities with the same owner 31

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

• Beaver Valley Hospital

  dba St. George Rehabilitation

  • Skilled Nursing Facility
  • St George, UT
  • NPI 1013452481

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Millcreek Rehabilitation and Nursing

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1023480225

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Four Corners Regional Care Center

  • Skilled Nursing Facility
  • Blanding, UT
  • NPI 1144528290

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Parkdale Health & Rehab

  • Skilled Nursing Facility
  • Price, UT
  • NPI 1154629350

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Highland Care Center

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1164651444

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  • Skilled Nursing Facility
  • St George, UT
  • NPI 1164881025

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Cascades At Orchard Park

  • Skilled Nursing Facility
  • Orem, UT
  • NPI 1164889457

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Heritage Park Healthcare and Rehabilitation

  • Skilled Nursing Facility
  • Roy, UT
  • NPI 1194257584

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Cascades at Riverwalk

  • Skilled Nursing Facility
  • Midvale, UT
  • NPI 1215344163

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Crestwood Rehabilitation and Nursing

  • Skilled Nursing Facility
  • Ogden, UT
  • NPI 1235587577

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Hurricane Health and Rehabilitation

  • Skilled Nursing Facility
  • Hurricane, UT
  • NPI 1235682501

  Beaver Valley Hospital

  CMS ownership
• Beaver Valley Hospital

  dba Copper Ridge Health Care

  • Skilled Nursing Facility
  • West Jordan, UT
  • NPI 1235682519

  Beaver Valley Hospital

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• David H Workman IX, MD

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1659329449

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1962955237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4782 S HOLLADAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175444",
            "telephone_number": "801-277-7002",
            "fax_number": "801-272-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4782 S HOLLADAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175444",
            "telephone_number": "801-277-7002",
            "fax_number": "801-272-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER VALLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER OF MANAGEMENT COMPANY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "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": "Holladay Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holladay Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beaver Valley Hospital (Paramount Therapy)
• Beaver Valley Hospital (Holladay Healthcare Center)
• Beaver Valley Hospital (Mt. Olympus Rehabilitation Center)
• Beaver Valley Hospital (Pine Creek Rehabilitation and Nursing)
• Beaver Valley Hospital (Woodland Park Rehabilitation and Care Center)
• Matthew David Beaver, MBBS
• Taylor R. Beaver, MD
• Margaret Grace Beazer, MD
• Zoe Beazer
• Maria Begona Becerra Martinez, DNP, FNP-C, APRN

• Skilled Nursing Facility in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.