Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1114965894 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1114965894","entity_type_code":"2"} |
| pac_id | 4284647090 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1114965894","rule":"D-PECOS","enrlmt_id":"O20060721000133","pecos_asct_cntl_id":"4284647090"} |
| pecos_enrlmt_id | O20060721000133 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1114965894","rule":"D-PECOS","enrlmt_id":"O20060721000133"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | AVAMERE SKILLED ADVISORS LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/01/2006","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0244551661","source_pk":40332,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | SABRA HEALTH CARE REIT INC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/17/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0941438881","source_pk":40334,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MICHELLE FUNDERBERG | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1153839816","source_pk":40335,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KARL RICKARD MILLER | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"10/06/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"1355250598","source_pk":40337,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | LORI BROCKBANK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/30/2016","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1759869688","source_pk":40338,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | ARI OPERATIONS, LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"10/06/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"2163694282","source_pk":40339,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KATHERINE FOWLER | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/28/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2163926841","source_pk":40340,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | ANDREW SIMPSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"06/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2769927185","source_pk":40342,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MIDCAP FINCO LLC (MD) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"37","association_date":"01/22/2010","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"2961915988","source_pk":40345,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"37","role_text_owner":"5% OR GREATER SECURITY INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | GLEN ROBERT CAVALLO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3072421676","source_pk":40347,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | ARISO LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/06/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"3072616960","source_pk":40348,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KEVALA TECHNOLOGIES, INC (WA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/07/2015","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3274011168","source_pk":40349,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | TRIAGE LLC (NE) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"11/17/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3375067879","source_pk":40350,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | CAROLYN STAPLES | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"10/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3476053711","source_pk":40351,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KARL RICKARD MILER JR REVOCABLE TRUST (ID) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"07/11/2011","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"3678081346","source_pk":40353,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | AVAMERE HEALTH SERVICES LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/01/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"3971635988","source_pk":40354,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MICHELLE LOEWEN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/09/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4183132848","source_pk":40356,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | HOLLY SUTTON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4385016625","source_pk":40358,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | IKE OKOLI | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789025479","source_pk":40360,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | TODD INSKEEP | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789192444","source_pk":40361,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | CONSOLIDATED BILLING SERVICES INC (WA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/24/1998","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789611914","source_pk":40363,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | VENTURA MEDSTAFF, LLC (NE) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5294236519","source_pk":40364,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | COLBY STRUNK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5395253058","source_pk":40365,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | JUSTIN POLSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496056632","source_pk":40367,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KAREN KAHN (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/01/2008","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5597828996","source_pk":40369,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | SHANNON BECERRA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5991283921","source_pk":40371,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | OWNER PAC 6103304092 (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/07/2015","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6103304092","source_pk":40373,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KIM GAMES | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/15/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6103326442","source_pk":40374,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | RANDE HOLDINGS, LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6305347626","source_pk":40375,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MICHELE POWELSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/25/2015","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6305354069","source_pk":40376,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | AVAMERE GROUP LLC (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/06/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"6507865482","source_pk":40379,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | TONIA CLARK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"07/24/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6709272743","source_pk":40380,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | NAOMI PREVATT | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/09/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800374836","source_pk":40382,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MARY KOFSTAD | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/13/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800962614","source_pk":40384,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | SABRA HEALTH CARE LIMITED PARTNERSHIP (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/17/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7113428434","source_pk":40387,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | YOLANDA PRESLEY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/06/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7113435876","source_pk":40388,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | NATIONAL STAFFING SOLUTIONS, INC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"11/22/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7214438530","source_pk":40390,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | JOLYNN MUNRO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"09/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7214445972","source_pk":40391,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | AEQUOR HEALTHCARE SERVICES, LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/20/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7315448628","source_pk":40394,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | INCOVATE SOLUTIONS, LLC (NC) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/21/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7315448636","source_pk":40395,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MARLON BOTHWELL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/19/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7719465640","source_pk":40396,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | CODY FEAKIN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"07/15/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7810239688","source_pk":40398,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MISTY DAWN REID | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/02/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7911314299","source_pk":40401,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | AMANDA SANDERS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8224569199","source_pk":40404,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | KEVIN HILL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8325556087","source_pk":40405,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | SABRA HEALTH CARE, LLC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/17/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8921509241","source_pk":40407,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | MOSS ADAMS LLP (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2009","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9234637075","source_pk":40408,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | DAMIEN HASKINS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"09/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9335572080","source_pk":40409,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | PIONEER HEALTHCARE SERVICES, LLC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"07/08/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9537647425","source_pk":40411,"type_owner":"O","enrollment_id":"O20060721000133","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
| ← owns | CARRIE VANDERZANDEN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9830607597","source_pk":40412,"type_owner":"I","enrollment_id":"O20060721000133","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"WATERFORD OPERATIONS, LLC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1114965894 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2006-06-03 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | WATERFORD OPERATIONS, LLC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | OR | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1114965894: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
Source:OIG LEIE +25 moreChecked 2026-09-20
14-tuple provenance (26)
OIG LEIE
source: HHS Office of Inspector General (LEIE)
dataset_id: oig-leie
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 1977-10-25
coverage_end: ongoing
slsa_provenance_url: —
SAM.gov Exclusions
source: U.S. General Services Administration (GSA), System for Award Management (SAM.gov)
dataset_id: sam-gov-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 2012-07-30
coverage_end: ongoing
slsa_provenance_url: —
NY Medicaid (OMIG)
source: NY Office of the Medicaid Inspector General (OMIG)
dataset_id: ny-omig-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: NY-OMIG-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
OH Medicaid (ODM)
source: Ohio Department of Medicaid (ODM)
dataset_id: oh-odm-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: OH-ODM-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
GA Medicaid (DCH OIG)
source: Georgia DCH Office of Inspector General
dataset_id: ga-dch-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: GA-DCH-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
PA Medicaid (Medicheck)
source: Pennsylvania Department of Human Services (DHS)
dataset_id: pa-dhs-medicheck
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: PA-DHS-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
NC Medicaid (DHHS)
source: NC DHHS, Division of Health Benefits (NC Medicaid)
dataset_id: nc-dhhs-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: NC-DHHS-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MD Medicaid
source: Maryland Department of Health (MDH)
dataset_id: md-mdh-sanctioned
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MD-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
WA Medicaid
source: Washington State Health Care Authority (HCA)
dataset_id: wa-hca-termination-exclusion
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: WA-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
IA Medicaid
source: Iowa Health and Human Services (Iowa Medicaid)
dataset_id: ia-medicaid-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: IA-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MS Medicaid
source: Mississippi Division of Medicaid (DOM)
dataset_id: ms-dom-sanctioned
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MS-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MT Medicaid
source: Montana Department of Public Health and Human Services (DPHHS)
dataset_id: mt-dphhs-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MT-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
CO Medicaid
source: Colorado Department of Health Care Policy & Financing (HCPF)
dataset_id: co-hcpf-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: CO-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
IN Medicaid
source: Indiana FSSA, Office of Medicaid Policy and Planning (OMPP)
dataset_id: in-ompp-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: IN-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
KS Medicaid
source: Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF)
dataset_id: ks-kmap-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: KS-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
KY Medicaid
source: Kentucky CHFS, Department for Medicaid Services (DMS)
dataset_id: ky-dms-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: KY-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
NH Medicaid
source: New Hampshire Department of Health and Human Services (DHHS)
dataset_id: nh-dhhs-sanctions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: NH-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
ND Medicaid
source: North Dakota Health and Human Services (HHS), Medicaid Program Integrity
dataset_id: nd-hhs-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: ND-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
TN Medicaid
source: Tennessee TennCare, Office of Program Integrity
dataset_id: tn-tenncare-terminated
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: TN-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MI Medicaid
source: Michigan Department of Health and Human Services (MDHHS), Medicaid Program Integrity
dataset_id: mi-mdhhs-sanctions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MI-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
LA Medicaid
source: Louisiana Department of Health (LDH), Program Integrity
dataset_id: la-ldh-adverse-actions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: LA-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
SC Medicaid
source: South Carolina Department of Health and Human Services (SCDHHS), Program Integrity
dataset_id: sc-scdhhs-sanctioned
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: SC-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MA Medicaid
source: Massachusetts MassHealth (EOHHS), Office of Program Integrity
dataset_id: ma-masshealth-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MA-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
MO Medicaid
source: Missouri Medicaid Audit and Compliance (MMAC), Department of Social Services
dataset_id: mo-mmac-sanctions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: MO-public-records
coverage_start: —
coverage_end: —
slsa_provenance_url: —
OIG CIA
source: HHS Office of Inspector General — Corporate Integrity Agreements
dataset_id: oig-cia
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: not_flagged, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: —
coverage_end: —
slsa_provenance_url: —
CMS Penalties
source: Centers for Medicare & Medicaid Services (CMS) — Civil Money Penalties
dataset_id: cms-cmp
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: not_flagged, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: —
coverage_end: —
slsa_provenance_url: —
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
Source:CMS Open PaymentsChecked 2026-09-20
14-tuple provenance (1)
CMS Open Payments
source: CMS Open Payments (Sunshine Act physician payment disclosures)
dataset_id: cms-open-payments
snapshot: —
methodology: open-payments/v1
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: not_present, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 2013-08-01
coverage_end: ongoing
slsa_provenance_url: —
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
Source:CMS Order and ReferringChecked 2026-09-20
14-tuple provenance (1)
CMS Order and Referring
source: Centers for Medicare & Medicaid Services (CMS)
dataset_id: cms-order-referring
snapshot: —
methodology: cms-order-referring/v1
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: not_present, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: —
coverage_end: ongoing
slsa_provenance_url: —
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
Source:CMS Opt Out AffidavitsChecked 2026-09-20
14-tuple provenance (1)
CMS Opt Out Affidavits
source: Centers for Medicare & Medicaid Services (CMS)
dataset_id: cms-opt-out-affidavits
snapshot: —
methodology: cms-opt-out/v1
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: not_present, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 1998-01-01
coverage_end: ongoing
slsa_provenance_url: —
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
Source:CMS Medicare Revalidation Due Date ListChecked 2026-09-20
14-tuple provenance (1)
CMS Medicare Revalidation Due Date List
source: Centers for Medicare & Medicaid Services (CMS)
dataset_id: cms-revalidation-due-dates
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T15:05:37.061Z
confidence: 1
data_availability: present, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 2011-03-25
coverage_end: ongoing
slsa_provenance_url: —
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…