SHADELANDS POST ACUTE
NPI 1033884473
Skilled Nursing Facility in Walnut Creek, CA

Active since August 09, 2021CLIA 05D2242715 · Waiver
2765 MITCHELL DR, WALNUT CREEK, CA 94598(925) 448-3782 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 20, 2024, Aug 6, 2024, Apr 3, 2023 and 2 more (5 updates tracked since 2021).

About Shadelands Post Acute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADELANDS POST ACUTE (NPI 1033884473) is a healthcare organization registered as a skilled nursing facility in Walnut Creek, California and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through November 9, 2027 and lists John Mitchell, Secretary, as its authorized official.

NPPES Registry Identity

NPI1033884473
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGREY PINE HOLDINGS, LLC
Location Address2765 MITCHELL DRWalnut Creek, CA 94598-1601
Mailing Address262 N University AveFarmington, UT 84025-2975
Organization SubpartNo
Authorized OfficialJohn MitchellSecretary · (385) 988-3319
Enumeration DateAugust 9, 2021
Last NPPES UpdateAugust 20, 20245 updates tracked since enumeration
NPPES CertifiedAugust 20, 2024
NPI 1033884473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
2765 MITCHELL DR, Walnut Creek, CA 94598

Other Names 1

Doing Business AsShadelands Post Acute

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2242715

Shadelands Post Acute · Walnut Creek, CA
Active · expires Nov 9, 2027
CLIA Number05D2242715
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorSri Vardhan Kooturu
Laboratory Phone(925) 551-1003
Laboratory LocationShadelands Post Acute2765 Mitchell Dr, Walnut Creek, CA 94598
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Shadelands Post Acute (CMS certification number 555926), from CMS Care Compare.

Shadelands Post Acute

Nursing home · Walnut Creek, CA
OwnershipFor profit - Individual
CMS Certification Number555926
Certified Beds59 beds58 residents per day on average
Medicare & Medicaid Participant SinceJuly 29, 2022
Automatic sprinkler system

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.24 · LPN 1.33 · RN 0.63
4.21 hrs per resident per day
Weekend Nurse Staffing
3.68 hrs per resident per day
Physical Therapist Staffing
0.25 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
50%
Registered Nurse Turnover
14.3%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
1
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
2765 MITCHELL DR
WALNUT CREEK, CA 94598
Occupational Therapist (Physical Rehabilitation)
2765 MITCHELL DR
WALNUT CREEK, CA 94598
Occupational Therapist
2765 MITCHELL DR
WALNUT CREEK, CA 94598

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grey Pine Holdings, LLC's NPI number?

The NPI number for Grey Pine Holdings, LLC is 1033884473. It was assigned to this organization in the NPPES registry on August 9, 2021. The provider is doing business as Shadelands Post Acute.

Where is Grey Pine Holdings, LLC located?

Grey Pine Holdings, LLC is located at 2765 Mitchell Dr, Walnut Creek, CA 94598. The listed phone number is (925) 448-3782.

What is Grey Pine Holdings, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Grey Pine Holdings, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2242715) is associated with this NPI, valid through November 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Grey Pine Holdings, LLC a Medicare-certified nursing home?

Yes. Shadelands Post Acute is a Medicare-certified nursing home with 59 certified beds.

When was this NPI record last updated?

The NPPES record for Grey Pine Holdings, LLC was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.