WILLOW CREEK RETIREMENT CENTER
NPI 1780758904
Skilled Nursing Facility in Jackson, MS

Active since November 20, 2006CLIA 25D0995919 · Waiver
1/5
Overall Rating
49 WILLOW CREEK LN, JACKSON, MS 39272(601) 863-4201(601) 863-4202 Get Directions Write a Review

NPPES record last updated: February 20, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Willow Creek Retirement Center NPPES

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

WILLOW CREEK RETIREMENT CENTER (NPI 1780758904) is a healthcare organization registered as a skilled nursing facility in Jackson, Mississippi and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through February 4, 2028 and lists David Rotolo, Member, as its authorized official.

NPPES Registry Identity

NPI1780758904
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWCRL, LLC
Location Address49 WILLOW CREEK LNJackson, MS 39272-9255
Mailing AddressPo Box 2712Ridgeland, MS 39158-2712 · (601) 853-2667 · Fax (601) 853-2116
Fax(601) 863-4202
Organization SubpartNo
Authorized OfficialDavid RotoloMember · (601) 853-2667
Enumeration DateNovember 20, 2006
Last NPPES UpdateFebruary 20, 2008
NPI 1780758904 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 MS · 926
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.
49 WILLOW CREEK LN, Jackson, MS 39272

Other Names 1

Doing Business AsWillow Creek Retirement Center

Other Identifiers 2

Medicare ID-Type Unspecified25-5300MS
Medicaid00230143MS

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 25D0995919

Willow Creek Retirement Center · Byram, MS
Active · expires Feb 4, 2028
CLIA Number25D0995919
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateFebruary 5, 2026
Certificate Expiration DateFebruary 4, 2028
Laboratory DirectorLisha Woodard
Laboratory Phone(601) 863-4201
Laboratory LocationWillow Creek Retirement Center49 Willow Creek Lane, Byram, MS 39272
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 Willow Creek Retirement Center (CMS certification number 255300), from CMS Care Compare.

Willow Creek Retirement Center

Nursing home · Byram, MS
1/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number255300
Certified Beds88 beds81 residents per day on average
Medicare & Medicaid Participant SinceAugust 1, 2003
Resident & Family CouncilResident and family councils
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.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
46.67
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 1.92 · LPN 1.09 · RN 0.55
3.57 hrs per resident per day
Weekend Nurse Staffing
3.17 hrs per resident per day
Physical Therapist Staffing
0.01 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
59.8%
Registered Nurse Turnover
50%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
5
Substantiated Complaints
4
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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 Wcrl, LLC's NPI number?

The NPI number for Wcrl, LLC is 1780758904. It was assigned to this organization in the NPPES registry on November 20, 2006. The provider is doing business as Willow Creek Retirement Center.

Where is Wcrl, LLC located?

Wcrl, LLC is located at 49 Willow Creek Ln, Jackson, MS 39272. The listed phone number is (601) 863-4201.

What is Wcrl, LLC's specialty?

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

Does Wcrl, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0995919) is associated with this NPI, valid through February 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Wcrl, LLC a Medicare-certified nursing home?

Yes. Willow Creek Retirement Center is a Medicare-certified nursing home with 88 certified beds.

What quality rating does Wcrl, LLC have?

CMS rates Willow Creek Retirement 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 Wcrl, LLC accept?

Health plans from Blue Cross and Blue Shield of Alabama list Wcrl, 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 Wcrl, LLC was last updated on February 20, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.