ST. JOSEPH VILLA
NPI 1255634879
Skilled Nursing Facility in Salt Lake City, UT
About St. Joseph Villa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ST. JOSEPH VILLA (NPI 1255634879) is a healthcare organization registered as a skilled nursing facility in Salt Lake City, Utah and active in the NPI registry since December 2010. The organization holds a CLIA Waiver certificate valid through October 19, 2028 and lists Soon Burnam, Treasurer Of Management Company, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
St. Joseph Villa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to St. Joseph Villa, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 46D2196926
St Joseph Villa Assisted Living · Salt Lake City, UTFrequently 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 Successor Healthcare LLC's NPI number?
The NPI number for Successor Healthcare LLC is 1255634879. It was assigned to this organization in the NPPES registry on December 21, 2010. The provider is doing business as St. Joseph Villa.
Where is Successor Healthcare LLC located?
Successor Healthcare LLC is located at 451 Bishop Federal Ln, Salt Lake City, UT 84115. The listed phone number is (801) 487-7557.
What is Successor Healthcare LLC's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Is Successor Healthcare LLC enrolled in Medicare?
Yes. Successor Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Successor Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Successor Healthcare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Successor Healthcare LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 46D2196926) is associated with this NPI, valid through October 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Successor Healthcare LLC was last updated on June 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.