OTTERBEIN CLEARCREEK, LLC (NPI# 1992977516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992977516 |
| Entity Type | Organization |
| Organization Name | OTTERBEIN CLEARCREEK, LLC |
| Other Organization Name | AVALON BY OTTERBEIN CLEAR CREEK |
| Practice Address |
9320 Avalon Circle Centerville OH 45458 |
| Mailing Address |
580 N State Route 741 Lebanon OH 45036-8839 |
| Practice Telephone | 9378855426 |
| Practice Fax Number | 9378854969 |
| Mailing Telephone | 5139335401 |
| Mailing Fax Number | 5139321054 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2015-02-09 |
| Authorized Official Name | JAMES CHRIS GREEN (TREASURER & CFO) |
| Authorized Official Telephone | 5139335418 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | 2518N | OH | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Avalon by Otterbein Clear Creek | Doing Business As Name - Organization |
| Street Address |
9320 AVALON CIRCLE |
| City | CENTERVILLE |
| State | OH |
| Zip Code | 45458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948170 | John M Duchak Md Cardiology LLC | Specialist | 1036 Wild Hickory Lane, Centerville, OH 45458 | 2020-09-24 |
| 1942833389 | Colleen Stevens | Counselor | 955 Sweeney Drive, Dayton, OH 45458 | 2020-02-13 |
| 1740770197 | Social Row Transitional Care, Inc. | Skilled Nursing Facility | 250 West Social Row Road, Centerville, OH 45458 | 2018-05-11 |
| 1326568833 | Mary Ann Horton | Registered Nurse | 1362 Hickoryview Ct, Dayton, OH 45458 | 2017-06-26 |
| 1487101911 | Brianna Burkman | Specialist/Technologist | 1400 Stone Ash Ct, Centerville, OH 45458 | 2016-09-01 |
| 1720434707 | Ascent Health, LLC | Community/Behavioral Health | 1162 Peachcreek Rd., Dayton, OH 45458 | 2016-05-10 |
| 1821450206 | Chi Living Communties | Skilled Nursing Facility | 1050 St. Leonard Way, Centerville, OH 45458 | 2016-03-24 |
| 1265842835 | Amanda Powell | Physical Therapist | 9582 Tahoe Drive, Centerville, OH 45458 | 2014-05-05 |
| 1255774337 | Rita Charlene Penley | Counselor | 99 South Main St, Centerville, OH 45458 | 2013-04-09 |
| 1447503933 | Martha Ann Sheldrick | Nurse Practitioner | 212 Walnut Grove Dr, Centerville, OH 45458 | 2012-10-21 |
| Find all providers in zip 45458 | ||||
| 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 |
|---|---|---|---|---|
| 1740770197 | Social Row Transitional Care, Inc. | Skilled Nursing Facility | 250 West Social Row Road, Centerville, OH 45458 | 2018-05-11 |
| 1821450206 | Chi Living Communties | Skilled Nursing Facility | 1050 St. Leonard Way, Centerville, OH 45458 | 2016-03-24 |
| 1467813030 | Chi Living Communities | Skilled Nursing Facility | 1203 Schervier Ct, Centerville, OH 45458-2778 | 2016-03-10 |
| 1326074402 | Centerville Medical Investors, LLC | Skilled Nursing Facility | 112 Old Dickson Road, Centerville, TN 37033 | 2006-06-23 |
| 1801836655 | Heartland of Centerville Oh LLC | Skilled Nursing Facility | 1001 E Alex Bell Rd, Centerville, OH 45459-2637 | 2006-06-08 |
| 1851361406 | Care Initiatives | Skilled Nursing Facility | 1208 E Cross St, Centerville, IA 52544-3501 | 2006-01-25 |
| 1942299185 | Cape Regency Ma Snf LLC | Skilled Nursing Facility | 120 South Main Street, Centerville, MA 02632 | 2005-10-20 |
| 1295722015 | Centerville Healthcare Center | Skilled Nursing Facility | 103 Teakwood, Centerville, TX 75833-2497 | 2005-10-06 |
| 1417445230 | Centerville Care & Rehab Center Inc | Skilled Nursing Facility | 500 Vermillion St, Centerville, SD 57014-2168 | 2018-04-26 |
| 1457752297 | Golden Age Properties LLC | Skilled Nursing Facility | 1915 S 18th St, Centerville, IA 52544-3102 | 2014-09-11 |
| Find all providers in CENTERVILLE | ||||
| City | CENTERVILLE |
| Zip Code | 45458 |
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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.