Organization Active NPI

Clearsky Rehabilitation Hospital of Lancaster, LLC

  • Rehabilitation Hospital
  • Lancaster, OH
National Provider Identifier
1083487169
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CLEARSKY REHABILITATION HOSPITAL OF LANCASTER, LLC
Practice address
1201 River Valley Blvd
Lancaster, OH 43130-1653
Phone
(740) 303-4300
Fax
(740) 303-4333
NPI assigned
Nov 1, 2023
Last updated
Nov 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 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 NU Primary

Addresses

Primary practice location

1201 River Valley Blvd
Lancaster, OH 43130-1653

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240628003806 OH Part A Provider - Hospital 0042754103 Practice locations: Lancaster, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083487169. Details of each certification follow.

Hospital certification: CCN 363048

Legal name
CLEARSKY REHABILITATION HOSPITAL OF LANCASTER LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Dec 18, 2024
Last certification
Dec 18, 2024
Beds
36
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jun 13, 2022 in DE
Enrollment address
1201 River Valley Blvd
Lancaster, OH 43130-1653
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Clearsky Rehabilitation Hospital of Lancaster LLCCCN 363048 · All quality measures
Ownership
For profit
Certified
Dec 18, 2024
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
36D2310078Clearsky Rehabilitation Hospital of Lancaster1201 River Valley Blvd, Lancaster, OH 43130Certificate of waiverAug 26, 2026

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 Jun 13, 2022 9.45%
BW Clearsky Aiv IV Indirect Feeder LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Jun 13, 2022 9.45%
BW Aiv IV Direct Feeder LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Jun 13, 2022 35.21%
Peloton Clearsky Inc Organization, Greenwich, CT Corporation 5% Or Greater Indirect Ownership Interest Jun 13, 2022 44.66%
Kristi L Duncan Individual Corporate OfficerCfo Jun 13, 2022
Peloton Clearsky LLC Organization, Greenwich, CT LLC 5% Or Greater Indirect Ownership Interest Jun 13, 2022 22.33%
Peloton Equity II LP Organization, Greenwich, CT 5% Or Greater Indirect Ownership Interest Jun 13, 2022 22.33%
Claude Darby Brockette Individual Corporate OfficerCeo Jun 13, 2022
Sheryl H Gentile Individual Corporate OfficerVice President Jun 13, 2022
Clearsky Health Acquisition LLC Organization, Albuquerque, NM LLC 5% Or Greater Direct Ownership Interest Jun 13, 2022 100%
Leavitt Equity Partners II LP Organization, Salt Lake City, UT 5% Or Greater Indirect Ownership Interest Jun 13, 2022 5.95%
Michael J Warrington Individual Corporate OfficerPresident Dec 2, 2024
Clearsky Health Intermediate LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Jun 13, 2022 100%
Adam Scott Van Dyke Individual W-2 Managing EmployeeHospital Ceo Aug 11, 2025
Operational/Managerial ControlHospital Ceo Aug 11, 2025
Clearsky Employee Holdings-a, LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Jun 13, 2022 4.74%
Charles Nathan Miller Individual W-2 Managing EmployeeInterim Hospital Ceo Jun 4, 2025
Operational/Managerial ControlSVP Operations Jun 13, 2022
Clearsky Health Holdings LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Jun 13, 2022 100%
Theodore B Lundberg Individual Corporate OfficerVice President Jun 13, 2022
Jeremy Michael Kogler Individual Corporate OfficerVice President Jun 13, 2022
BW Clearsky Aiv IV LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Jun 13, 2022 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, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

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": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1083487169",
    "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",
            "fax_number": "833-642-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RIVER VALLEY BLVD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301653",
            "telephone_number": "740-303-4300",
            "fax_number": "740-303-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARSKY REHABILITATION HOSPITAL OF LANCASTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.