SAPPHIRE AT CEDAR CROSSINGS, LLC (NPI# 1962025809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962025809 |
| Entity Type | Organization |
| Organization Name | SAPPHIRE AT CEDAR CROSSINGS, LLC |
| Practice Address |
6003 Se 136th Ave Portland OR 97236-4567 |
| Mailing Address |
127 Ne 102nd Ave Ste A Portland OR 97220-4152 |
| Practice Telephone | 5038877395 |
| Mailing Telephone | 5034462877 |
| Mailing Fax Number | 9712305846 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| Authorized Official Name | KEVIN MICHAEL RICKER (MANAGING MEMBER) |
| Authorized Official Telephone | 5038877395 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Cedar Crossings | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SAPPHIRE AT CEDAR CROSSINGS, LLC | 6003 Se 136th Ave, Portland, OR 97236 |
| Street Address |
6003 SE 136TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-4567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205053600 | St. Jude Operating Company, LLC | Nursing Facility/Intermediate Care Facility | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2007-04-19 |
| 1568008654 | Jennifer Blair | Counselor | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2019-11-23 |
| 1982254579 | Miranda Boyte | Occupational Therapy Assistant | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2019-09-16 |
| 1982179644 | Abhinaya Srinivasan | Speech-Language Pathologist | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2018-10-09 |
| 1457765612 | Camelia Mayfield | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2014-06-16 |
| 1538598206 | Jacqueline Bitner | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2013-11-04 |
| 1164864930 | Diana Gates | Counselor | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2013-07-22 |
| 1164784526 | Bryan Joseph Ingram | Adult Companion | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-06-12 |
| 1952667669 | Foster Creek Operating Company, LLC | Nursing Facility/Intermediate Care Facility | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-04-06 |
| 1760757579 | Sarah Nicole Dowdy | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-03-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
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| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861835456 | Marquis Companies II, Inc. | Skilled Nursing Facility | 319 Ne Russet St, Portland, OR 97211-2815 | 2013-04-12 |
| 1942437298 | Anita August | Skilled Nursing Facility | 300 Nw 8th Ave Apt 707, Portland, OR 97209-3560 | 2009-06-14 |
| 1720151988 | Care Center East Health - Portland, LLC | Skilled Nursing Facility | 11325 Ne Weidler St, Portland, OR 97220-1950 | 2006-11-16 |
| 1659470193 | Eagle Healthcare, Inc | Skilled Nursing Facility | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2006-09-21 |
| 1932211968 | Marquis Companies I, Inc | Skilled Nursing Facility | 725 Se 202nd Ave, Portland, OR 97233-6105 | 2006-08-31 |
| 1508978537 | Marquis Companies I, Inc | Skilled Nursing Facility | 1475 Se 100th Ave, Portland, OR 97216-2537 | 2006-08-31 |
| 1942312905 | Marquis Companies I, Inc | Skilled Nursing Facility | 6010 Sw Shattuck Rd, Portland, OR 97221-1043 | 2006-08-31 |
| 1205841095 | Adventist Health System Texas, Inc. | Skilled Nursing Facility | 215 Highland Circle Dr, Portland, TN 37148-4918 | 2006-07-30 |
| 1629008651 | Harbor Care Corporation | Skilled Nursing Facility | 3540 Se Francis St, Portland, OR 97202-3350 | 2006-07-04 |
| 1114969912 | West Hills Convalescent Center Limited Partnership | Skilled Nursing Facility | 5701 Sw Multnomah Blvd, Portland, OR 97219-3195 | 2006-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.