DEEP CREEK RNC, LLC


Address: 25325 Rampart Blvd, Port Charlotte, FL 33983
Phone: 9416297466

DEEP CREEK RNC, LLC (NPI# 1679560262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679560262
Entity Type Organization
Organization Name DEEP CREEK RNC, LLC
Other Organization Name PORT CHARLOTTE REHABILITATION CENTER
Practice Address 25325 Rampart Blvd
Port Charlotte
FL 33983
Mailing Address 25325 Rampart Blvd
Port Charlotte
FL 33983-6404
Practice Telephone 9416297466
Practice Fax Number 9416299053
Mailing Telephone 9416297466
Mailing Fax Number 9416299053
Enumeration Date 2005-09-29
Last Update Date 2018-06-12
Authorized Official Name MR. SAMUEL B KELLETT (MANAGING MEMBER OF SBK CAPITAL LLC)
Authorized Official Telephone 4042337048
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility SNF14260961 FL Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
FL 0319325 00 05
VA V516P-6820 01

Other Provider/Organization Names

Other Name Type Code
Port Charlotte Rehabilitation Center Doing Business As Name - Organization

Office Location

Street Address 25325 RAMPART BLVD
City PORT CHARLOTTE
State FL
Zip Code 33983

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700118742 Luigi Amabile Jr. Occupational Therapy Assistant 25325 Rampart Blvd, Port Charlotte, FL 33983-6404 2010-02-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114327244 Alexandra Fichetti Counselor 1196-j Rio De Janeiro. Ave, Punta Gorda, FL 33983 2014-08-26
1164749719 Larry D. Rand Physician Assistant 27289 Voyageur Dr., Punta Gorda, FL 33983 2010-04-22
1912039223 Wal-mart Stores, Inc. Technician/Technologist 375 Kings Highway, Port Charlotte, FL 33983 2007-03-12
1669552360 Paul Edward Tuma Pharmacist 2000 Kings Highway, Port Charlotte, FL 33983 2006-10-17
1013007145 Amy Louise Houser Social Worker 26559 Barraquilla Avenue, Punta Gorda, FL 33983 2006-10-12
1447677208 Karen Partridge Pharmacist 375 Kings Hwy, Wal-mart Pharmacy 3349, Port Charlotte, FL 33983 2014-03-18
1104261650 North Port Retirement Centers, Inc. Assisted Living Facility 24949 Sandhill Blvd, Punta Gorda, FL 33983 2013-05-09
1194864009 Petrija Jen Do Pa Personal Emergency Response Attendant 24451 Sandhill Blvd, Suite A, Punta Gorda, FL 33983 2007-02-06
1518414994 Kristen Cuellar Clinic/Center 2428 Nuremberg Blvd, Punta Gorda, FL 33983-2609 2016-09-02
1457652935 Aggies's Place, Inc. In Home Supportive Care 2428 Nuremberg Blvd., Punta Gorda, FL 33983-2609 2010-11-15
Find all providers in zip 33983

Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy 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.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396754230 Health Center of Port Charlotte Inc Skilled Nursing Facility 4000 Kings Hwy, Port Charlotte, FL 33980-8413 2006-08-07
1043233992 Port Charlotte Facility Operations, LLC Skilled Nursing Facility 18480 Cochran Blvd, Port Charlotte, FL 33948-3379 2006-07-25
1396778825 Hqm of Port Charlotte, LLC Skilled Nursing Facility 4033 Beaver Ln, Port Charlotte, FL 33952-9206 2006-07-08
1740220227 Tandem Health Care of Port Charlotte, Inc. Skilled Nursing Facility 18480 Toledo Blade Blvd, Port Charlotte, FL 33948-3379 2006-06-07
1124002647 Peace River Hma Nursing Center Inc Skilled Nursing Facility 2370 Harbor Blvd, Port Charlotte, FL 33952 2005-11-30
1275904864 Solaris Healthcare Charlotte Harbor LLC Skilled Nursing Facility 4000 Kings Hwy, Port Charlotte, FL 33980-8718 2015-10-08
1033586060 Mary Samoge-wismer Skilled Nursing Facility 18480 Cochran Blvd, Port Charlotte, FL 33948-3379 2015-08-25
1376957803 Ccrc - South Port Square, LLC Skilled Nursing Facility 23013 Westchester Blvd, Port Charlotte, FL 33980-8448 2014-06-12
1467761783 Charlotte Harbor Rehab LLC Skilled Nursing Facility 4000 Kings Hwy, Port Charlotte, FL 33980-8718 2010-10-04
1801062880 Village Place Nh LLC Skilled Nursing Facility 2370 Harbor Blvd, Port Charlotte, FL 33952-5024 2008-04-30
Find all providers in PORT CHARLOTTE

Competitor

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City PORT CHARLOTTE
Zip Code 33983

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Dataset Information

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.

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