Cedar Creek at Kings Bay, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10230 Issued in FL

Legal business name

CEDAR CREEK AT KINGS BAY, INC

Doing business as

Cedar Creek

Practice address

231 NW Hwy 19
Crystal River, FL 34428

Phone

(352) 564-2446

NPI assigned

May 14, 2013

Last updated

May 14, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Heather Stevens

Title

Assistant Director

Phone

(352) 564-2446

Specialties & licenses 1

Addresses

Other names 1

• Cedar Creek Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1104262302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 NW HWY 19",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34428",
            "telephone_number": "352-564-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 NW HWY 19",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34428",
            "telephone_number": "352-564-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK AT KINGS BAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "352-564-2446",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendal Suzanne Carroll
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• Rachel Caudill, COTA
• CDPG, P.L. (Christie Dental of Meadowcrest)
• Chara Powers Celano, M.A.CCC,SLP
• Philip A Cenatiempo
• Central Florida Clinic for Rehabilitation
• Melanie Chacon
• Karen M Champagne-Lister, LSW

• Assisted Living Facility in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.