200 WHITMAN AVENUE OPCO LLC
NPI 1609450386
Skilled Nursing Facility in Elkins, WV

Active since May 10, 2021CLIA 51D0886558 · Waiver
1/5
Overall Rating
200 WHITEMAN AVE, ELKINS, WV 26241(877) 567-0402 Get Directions Write a Review

NPPES record last updated: March 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 200 Whitman Avenue Opco Llc NPPES

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

200 WHITMAN AVENUE OPCO LLC (NPI 1609450386), doing business as Autumn Lake Healthcare At Crystal Springs, is a healthcare organization registered as a skilled nursing facility in Elkins, West Virginia and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through May 22, 2028 and lists Sam Stern, Cfo, as its authorized official.

NPPES Registry Identity

NPI1609450386
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name200 WHITMAN AVENUE OPCO LLC
Location Address200 WHITEMAN AVEElkins, WV 26241-3400
Mailing Address14c 53rd StBrooklyn, NY 11232-2644 · (877) 567-0402
Organization SubpartNo
Authorized OfficialSam SternCfo · (877) 567-0402
Enumeration DateMay 10, 2021
Last NPPES UpdateMarch 14, 2022
NPPES CertifiedMarch 14, 2022
NPI 1609450386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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.
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X
Also ListedRespite CareTaxonomy 385H00000X
200 WHITEMAN AVE, Elkins, WV 26241

Other Names 1

Doing Business AsAutumn Lake Healthcare At Crystal Springs

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 51D0886558

200 Whitman Avenue Opco LLC Dba Autumn Lake Healthcare At Crystal Springs · Elkins, WV
Active · expires May 22, 2028
CLIA Number51D0886558
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMay 23, 2026
Certificate Expiration DateMay 22, 2028
Laboratory DirectorRose Holicker
Laboratory Phone(304) 636-2033
Laboratory Location200 Whitman Avenue Opco LLC Dba Autumn Lake Healthcare At Crystal Springs200 Whitman Avenue, Elkins, WV 26241
CLIA data matches this NPI record on: Name
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 Autumn Lake Healthcare At Crystal Springs (CMS certification number 515197), from CMS Care Compare.

Autumn Lake Healthcare At Crystal Springs

Nursing home · Elkins, WV
1/5 CMS Overall Rating
OwnershipFor profit - Partnership
CMS Certification Number515197
Certified Beds84 beds78 residents per day on average
Medicare & Medicaid Participant SinceDecember 23, 2021
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
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.
4/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
152
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 2.08 · LPN 0.88 · RN 0.28
3.24 hrs per resident per day
Weekend Nurse Staffing
2.83 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
72.1%
Registered Nurse Turnover
87.5%
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
0
Substantiated Complaints
10
Fines
5 totaling $7,088.51
Medicare Payment Denials
0
Total Penalties
5
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 2

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

Optometrist
200 WHITEMAN AVE
ELKINS, WV 26241
Nursing Facility/Intermediate Care Facility
200 WHITEMAN AVE, CRYSTAL SPRINGS
ELKINS, WV 26241

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 200 Whitman Avenue Opco LLC's NPI number?

The NPI number for 200 Whitman Avenue Opco LLC is 1609450386. It was assigned to this organization in the NPPES registry on May 10, 2021. The provider is doing business as Autumn Lake Healthcare at Crystal Springs.

Where is 200 Whitman Avenue Opco LLC located?

200 Whitman Avenue Opco LLC is located at 200 Whiteman Ave, Elkins, WV 26241. The listed phone number is (877) 567-0402.

What is 200 Whitman Avenue Opco LLC's specialty?

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

Does 200 Whitman Avenue Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D0886558) is associated with this NPI, valid through May 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is 200 Whitman Avenue Opco LLC a Medicare-certified nursing home?

Yes. Autumn Lake Healthcare At Crystal Springs is a Medicare-certified nursing home with 84 certified beds.

What quality rating does 200 Whitman Avenue Opco LLC have?

CMS rates Autumn Lake Healthcare At Crystal Springs 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for 200 Whitman Avenue Opco LLC was last updated on March 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.