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COMMONS AT JACKSON CREEK LLC
NPI 1821963091
Assisted Living Facility in Bloomington, IN

Active since October 08, 2025CLIA 15D1019642 · Waiver
3802 S SARE RD, BLOOMINGTON, IN 47401(260) 740-3220(260) 498-2059 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Commons At Jackson Creek Llc NPPES

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

COMMONS AT JACKSON CREEK LLC (NPI 1821963091) is a healthcare organization registered as an assisted living facility in Bloomington, Indiana and active in the NPI registry since October 2025. The organization holds a CLIA Waiver certificate valid through November 23, 2027 and lists Sherri Berghoff, Member/ceo, as its authorized official.

NPPES Registry Identity

NPI1821963091
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOMMONS AT JACKSON CREEK LLC
Location Address3802 S SARE RDBloomington, IN 47401-4794
Mailing Address5904 E State BlvdFort Wayne, IN 46815-7637 · (260) 740-3220 · Fax (260) 498-2059
Phone(260) 740-3220
Fax(260) 498-2059
Organization SubpartNo
Authorized OfficialSherri BerghoffMember/ceo · (260) 740-3220
Enumeration DateOctober 8, 2025
NPPES CertifiedOctober 8, 2025
✔ NPI 1821963091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3802 S SARE RD, Bloomington, IN 47401
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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 15D1019642

Commons At Jackson Creek, LLC · Bloomington, IN
Active · expires Nov 23, 2027
CLIA Number15D1019642
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 24, 2025
Certificate Expiration DateNovember 23, 2027
Laboratory DirectorCrystal Hunt
Laboratory Phone(812) 330-0885
Laboratory LocationCommons At Jackson Creek, LLC3802 S Sare Road, Bloomington, IN 47401
CLIA data matches this NPI record on: Address Name
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.

KGC OPERATOR, INC.
Assisted Living Facility
3802 S SARE RD
BLOOMINGTON, IN 47401
Monroe County (812) 330-0885

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 Commons At Jackson Creek LLC's NPI number?

The NPI number for Commons At Jackson Creek LLC is 1821963091. It was assigned to this organization in the NPPES registry on October 8, 2025.

Where is Commons At Jackson Creek LLC located?

Commons At Jackson Creek LLC is located at 3802 S Sare Rd, Bloomington, IN 47401. The listed phone number is (260) 740-3220.

What is Commons At Jackson Creek LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Commons At Jackson Creek LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1019642) is associated with this NPI, valid through November 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Commons At Jackson Creek LLC was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.