CRYSTAL RIVER HEALTH & REHABILITATION CENTER
NPI 1396790622
Skilled Nursing Facility in Crystal River, FL

Active since May 24, 2006CLIA 10D0860809 · Waiver
136 NE 12TH AVE, CRYSTAL RIVER, FL 34429(352) 795-5044 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Crystal River Health & Rehabilitation Center NPPES

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

CRYSTAL RIVER HEALTH & REHABILITATION CENTER (NPI 1396790622) is a healthcare organization registered as a skilled nursing facility in Crystal River, Florida and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through April 17, 2028 and lists Phillip Cody Long, Cfo, as its authorized official.

NPPES Registry Identity

NPI1396790622
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameNORTHPORT HEALTH SERVICES OF FLORIDA, LLC
Location Address136 NE 12TH AVECrystal River, FL 34429-4553
Mailing Address136 Ne 12th AveCrystal River, FL 34429-4553
Organization SubpartNo
Authorized OfficialPhillip Cody LongCfo · (204) 391-3600
Enumeration DateMay 24, 2006
Last NPPES UpdateOctober 27, 2020
NPPES CertifiedOctober 27, 2020
NPI 1396790622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in FL · SNF1114096
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.
136 NE 12TH AVE, Crystal River, FL 34429

Other Names 1

Doing Business AsCrystal River Health & Rehabilitation Center

Other Identifiers 1

Medicaid021726300FL

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 10D0860809

Crystal River Health And Rehabilitation Center · Crystal River, FL
Active · expires Apr 17, 2028
CLIA Number10D0860809
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 18, 2026
Certificate Expiration DateApril 17, 2028
Laboratory DirectorPeter Misura
Laboratory Phone(352) 795-5044
Laboratory LocationCrystal River Health And Rehabilitation Center136 NE 12th Ave, Crystal River, FL 34429
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Speech-Language Pathologist
136 NE 12TH AVE
CRYSTAL RIVER, FL 34429

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 Northport Health Services Of Florida, LLC's NPI number?

The NPI number for Northport Health Services Of Florida, LLC is 1396790622. It was assigned to this organization in the NPPES registry on May 24, 2006. The provider is doing business as Crystal River Health & Rehabilitation Center.

Where is Northport Health Services Of Florida, LLC located?

Northport Health Services Of Florida, LLC is located at 136 NE 12th Ave, Crystal River, FL 34429. The listed phone number is (352) 795-5044.

What is Northport Health Services Of Florida, LLC's specialty?

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

Does Northport Health Services Of Florida, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0860809) is associated with this NPI, valid through April 17, 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 Northport Health Services Of Florida, LLC was last updated on October 27, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.