CREEKWOOD PLACE NURSING & REHAB CENTER, INC.
NPI 1619982410
Skilled Nursing Facility in Russellville, KY

Active since July 30, 2006CLIA 18D0672165 · Waiver
107 BOYLES DR, RUSSELLVILLE, KY 42276(270) 726-9049(270) 726-8706 Get Directions Write a Review

NPPES record last updated: December 30, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Creekwood Place Nursing & Rehab Center, Inc. NPPES

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

CREEKWOOD PLACE NURSING & REHAB CENTER, INC. (NPI 1619982410) is a healthcare organization registered as a skilled nursing facility in Russellville, Kentucky and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David Rodman, Asst Secretary, as its authorized official.

NPPES Registry Identity

NPI1619982410
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCREEKWOOD PLACE NURSING & REHAB CENTER, INC.
Location Address107 BOYLES DRRussellville, KY 42276-8838
Mailing Address485 N Keller Rd, Suite 250Maitland, FL 32751-7503 · (407) 975-3000 · Fax (407) 975-3090
Fax(270) 726-8706
Organization SubpartNo
Authorized OfficialDavid RodmanAsst Secretary · (407) 975-3011
Enumeration DateJuly 30, 2006
Last NPPES UpdateDecember 30, 2015
NPI 1619982410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in KY · 100299
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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 90003948 (KY)
107 BOYLES DR, Russellville, KY 42276

Other Identifiers 4

Medicaid90003948KY
Medicare NSC5853270002
Medicaid7100025410KY
Medicare OSCAR/certification185313KY

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 18D0672165

Creekwood Nursing And Rehabilitation Russellville Ky Opco LLC · Russellville, KY
Active · expires Aug 31, 2026
CLIA Number18D0672165
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMs. Christy Jordan
Laboratory Phone(270) 726-9049
Laboratory LocationCreekwood Nursing And Rehabilitation Russellville Ky Opco LLC107 Boyles Drive, Russellville, KY 42276
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 4

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

Skilled Nursing Facility
107 BOYLES DR
RUSSELLVILLE, KY 42276
Speech-Language Pathologist
107 BOYLES DR
RUSSELLVILLE, KY 42276
Skilled Nursing Facility
107 BOYLES DR
RUSSELLVILLE, KY 42276
Nurse Practitioner (Family)
107 BOYLES DR
RUSSELLVILLE, KY 42276

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619982410, enumerated as an "organization" on July 30, 2006.

The provider is located at 107 BOYLES DR RUSSELLVILLE, KY 42276 and the phone number is (270) 726-9049.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.