Organization Active NPI

Clearsky Rehabilitation Hospital of Rio Rancho LLC

  • Rehabilitation Hospital
  • Rio Rancho, NM
National Provider Identifier
1093341810
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC
Practice address
2401 Westside Blvd
Rio Rancho, NM 87124
Phone
(505) 317-3802
NPI assigned
Mar 13, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kristi Duncan
Title
VP
Phone
(505) 317-3988

Facilities with the same owner 13

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

View all 13

Practitioners 2

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

Affiliated clinicians 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Clearsky Rehabilitation Hospital of Rio Rancho LLCCCN 323033
Ownership
For profit
Certified
Feb 10, 2021
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
32D2192044Clearsky Rehabilitation Hospital of Rio Rancho LLC2401 Westside Blvd, Rio Rancho, NM 87124Certificate of waiverSep 2, 2026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200715000965 NM Part A Provider - Hospital 4385067958 Practice locations: Rio Rancho, NM

Hospital certification: CCN 323033

Legal name
CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC
Doing business as
CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Feb 10, 2021
Last certification
Jan 5, 2024
Beds
37
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Mar 4, 2020 in DE
Enrollment address
2401 Westside Blvd SE
Rio Rancho, NM 87124-4774
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

All disclosed owners & managing parties 19

Medicare enrollment files

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 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 OfficerCfo Mar 5, 2020
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%
Claude Darby Brockette Individual Corporate OfficerPresident Mar 5, 2020
Sheryl H Gentile Individual Corporate OfficerVice President Mar 5, 2020
Clearsky Health Acquisition LLC Organization, Albuquerque, NM LLC 5% Or Greater Direct Ownership Interest Mar 4, 2020 100%
Leavitt Equity Partners II LP Organization, Salt Lake City, UT 5% Or Greater Indirect Ownership Interest Nov 17, 2023 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 Mar 4, 2020 100%
Clearsky Employee Holdings-a, LLC Organization, New York, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 17, 2023 4.74%
Donna S Wilbur Individual W-2 Managing EmployeeCeo Aug 10, 2020
Clearsky Health Holdings LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Mar 4, 2020 100%
Theodore B Lundberg Individual Corporate OfficerVice President Mar 5, 2020
Jeremy Michael Kogler Individual Corporate OfficerVice President Mar 5, 2020
BW Clearsky Aiv IV LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 44.66%

National Provider Directory

National Provider Directory

Locations

2401 Westside Blvd SE
Rio Rancho, NM 87124
Phone (505) 295-6358

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

2401 Westside Blvd
Rio Rancho, NM 87124

Mailing address

5600 Wyoming Blvd NE Ste 225
Albuquerque, NM 87109-3136
Phone (505) 295-6358

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 20, 2023.

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1093341810",
    "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": "505-295-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 WESTSIDE BLVD",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-317-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARSKY REHABILITATION HOSPITAL OF RIO RANCHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "VP",
        "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 Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.