Organization Active NPI

Clearsky Rehabilitation Hospital of Mansfield, LLC

  • Rehabilitation Hospital
  • Mansfield, TX
National Provider Identifier
1013665124
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CLEARSKY REHABILITATION HOSPITAL OF MANSFIELD, LLC
Practice address
267 N State Highway 360
Mansfield, TX 76063-9073
Phone
(817) 778-9361
NPI assigned
Mar 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristi Duncan
Title
Cfo
Phone
(505) 317-3988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

267 N State Highway 360
Mansfield, TX 76063-9073

Mailing address

5600 Wyoming Blvd NE Ste 225
Albuquerque, NM 87109-3136
Phone (303) 845-0223

Other practice location 1

50 Indian Dr
Waxahachie, TX 75165-2579
Phone (972) 924-9440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230206001773 TX Part A Provider - Hospital 3870965551 Practice locations: Mansfield, TX; Waxahachie, TX

Hospital certification: CCN 673088

Legal name
CLEARSKY REHABILITATION HOSPITAL OF MANSFIELD LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jul 26, 2023
Last certification
Jul 26, 2023
Beds
60
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
267 N. State Highway 360
Mansfield, TX 76063-9073
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation, Other

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Clearsky Rehabilitation Hospital of MansfieldCCN 673088
Ownership
For profit
Certified
Jul 26, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2283117Clearsky Rehabilitation Hospital of Mansfield, LLC267 North State Highway 360, Mansfield, TX 76063Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
BW Clearsky Aiv IV C Corp Organization, New York, NY Corporation 5% Or Greater Indirect Ownership Interest Nov 17, 2023 9.45%
BW Clearsky Aiv IV Indirect Feeder LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 9.45%
BW Aiv IV Direct Feeder LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 35.21%
Peloton Clearsky Inc Organization, Greenwich, CT Corporation 5% Or Greater Indirect Ownership Interest Nov 17, 2023 44.66%
Kristi L Duncan Individual Corporate Officer Sep 1, 2021
Peloton Clearsky LLC Organization, Greenwich, CT LLC 5% Or Greater Indirect Ownership Interest Nov 17, 2023 22.33%
Peloton Equity II LP Organization, Greenwich, CT 5% Or Greater Indirect Ownership Interest Nov 17, 2023 22.33%
Steven K Bailey Individual W-2 Managing EmployeeCeo CSRH Waxahachie Jan 25, 2023
Operational/Managerial ControlCeo CSRH Waxahachie Jan 25, 2023
Claude Darby Brockette Individual Corporate Officer Sep 1, 2021
Sheryl H Gentile Individual Corporate OfficerVice President, Secretary Sep 1, 2021
Clearsky Health Acquisition LLC Organization, Albuquerque, NM LLC 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%
Leavitt Equity Partners II LP Organization, Salt Lake City, UT 5% Or Greater Indirect Ownership Interest Nov 17, 2023 5.95%
Lucky Denenga Individual W-2 Managing EmployeeCeo CSRH Mansfield Apr 13, 2026
Operational/Managerial ControlCeo CSRH Mansfield Apr 13, 2026
Michael J Warrington Individual Corporate OfficerPresident Dec 2, 2024
Clearsky Health Intermediate LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2021 100%
Clearsky Employee Holdings-a, LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Nov 17, 2023 4.74%
Clearsky Health Holdings LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2021 100%
Theodore B Lundberg Individual Corporate Officer Sep 1, 2021
Jeremy Michael Kogler Individual Corporate Officer Sep 1, 2021
BW Clearsky Aiv IV LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 44.66%

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1013665124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 WYOMING BLVD NE STE 225",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093136",
            "telephone_number": "303-845-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 N STATE HIGHWAY 360",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639073",
            "telephone_number": "817-778-9361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Indian Dr",
            "address_purpose": "LOCATION",
            "city": "Waxahachie",
            "state": "TX",
            "postal_code": "751652579",
            "country_code": "US",
            "telephone_number": "972-924-9440",
            "fax_number": "972-924-9445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLEARSKY REHABILITATION HOSPITAL OF MANSFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "505-317-3988"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.