BLUE RIDGE BY THE LAKE LLC
NPI 1154787141
Skilled Nursing Facility in St Petersburg, FL

Active since January 07, 2016CLIA 10D0718606 · Waiver
1/5
Overall Rating
1100 66TH ST N, ST PETERSBURG, FL 33710(727) 345-9331 Get Directions Write a Review

NPPES record last updated: January 7, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Blue Ridge By The Lake Llc NPPES

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

BLUE RIDGE BY THE LAKE LLC (NPI 1154787141) is a healthcare organization registered as a skilled nursing facility in St Petersburg, Florida and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Levi Rudd, Ceo, as its authorized official.

NPPES Registry Identity

NPI1154787141
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameBLUE RIDGE BY THE LAKE LLC
Location Address1100 66TH ST NSt Petersburg, FL 33710-6224
Mailing Address2700 N 29th Ave, Suite 308Hollywood, FL 33020-1520 · (786) 358-5200
Organization SubpartNo
Authorized OfficialLevi RuddCeo · (786) 358-5200
Enumeration DateJanuary 7, 2016
NPI 1154787141 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.
1100 66TH ST N, St Petersburg, FL 33710

Accepted Insurance

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 10D0718606

Blue Ridge By The Lake LLC Dba Eagle Lake Nursing And Rehab Care Center · Saint Petersburg, FL
Active · expires Aug 31, 2026
CLIA Number10D0718606
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorLewis Hubbard
Laboratory Phone(727) 345-9331
Laboratory LocationBlue Ridge By The Lake LLC Dba Eagle Lake Nursing And Rehab Care Center1100 66th St N, Saint Petersburg, FL 33710
CLIA data matches this NPI record on: Name Phone
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 Eagle Lake Nursing And Rehab Care Center (CMS certification number 105292), from CMS Care Compare.

Eagle Lake Nursing And Rehab Care Center

Nursing home · Saint Petersburg, FL
1/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number105292
Certified Beds59 beds47 residents per day on average
Medicare & Medicaid Participant SinceJanuary 7, 1976
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
1/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
196.5
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.21 · LPN 0.79 · RN 0.38
3.37 hrs per resident per day
Weekend Nurse Staffing
3.6 hrs per resident per day
Physical Therapist Staffing
0.03 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
82.3%
Registered Nurse Turnover
100%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
2
Substantiated Complaints
8
Fines
2 totaling $169,385.50
Medicare Payment Denials
0
Total Penalties
2
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 7

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

Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Nursing Facility/Intermediate Care Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Social Worker (Clinical)
1100 66TH ST N
ST PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
SAINT PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Physical Therapist
1100 66TH ST N
ST PETERSBURG, FL 33710

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 Blue Ridge By The Lake LLC's NPI number?

The NPI number for Blue Ridge By The Lake LLC is 1154787141. It was assigned to this organization in the NPPES registry on January 7, 2016.

Where is Blue Ridge By The Lake LLC located?

Blue Ridge By The Lake LLC is located at 1100 66th St N, St Petersburg, FL 33710. The listed phone number is (727) 345-9331.

What is Blue Ridge By The Lake LLC's specialty?

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

Does Blue Ridge By The Lake LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0718606) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Blue Ridge By The Lake LLC a Medicare-certified nursing home?

Yes. Eagle Lake Nursing And Rehab Care Center is a Medicare-certified nursing home with 59 certified beds.

What quality rating does Blue Ridge By The Lake LLC have?

CMS rates Eagle Lake Nursing And Rehab Care Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Blue Ridge By The Lake LLC accept?

Health plans from Molina Healthcare list Blue Ridge By The Lake LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blue Ridge By The Lake LLC was last updated on January 7, 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.