Spring Creek Nursing and Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SPRING CREEK NURSING AND REHABILITATION CENTER, LLC

Practice address

401 N Broadway St
Green Springs, OH 44836-9653

Phone

(419) 639-2581

NPI assigned

Dec 1, 2020

Organization subpart

No

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

Authorized official

Name

Joshua Koenig

Title

President

Phone

(419) 639-2581

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Skilled nursing facility certification: CCN 365101

Legal name

SPRING CREEK NURSING AND REHABILITATION CENTER LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1967

Last certification

Feb 15, 2024

Beds

120

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Dec 18, 2020

Organization structure

LLCProprietary

Incorporated

Oct 15, 2020 in OH

Enrollment address

401 N Broadway St
Green Springs, OH 44836-9653

Nursing home name

SPRING CREEK NURSING AND REHABILITATION CENTER LLC

Listed as

Spring Creek Nursing and Rehabilitation Center LLCCCN 365101

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12071.6 residents per day on average

Penalties (3 years)

1Fines totaling $77,618

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 6

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

Practitioners 2

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

• Rugen M Alda, MD

  • Family Medicine Physician
  • Clyde, OH
  • NPI 1750340022
  NPD (past)
• Daniel B Berry, MD

  • Internal Medicine Physician
  • Clyde, OH
  • NPI 1669431938
  NPD (past)

Affiliated clinicians 2

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

• Rugen M Alda, MD

  • Family Medicine Physician
  • Clyde, OH
  • NPI 1750340022

  Nursing home

  Care Compare affiliation
• Daniel B Berry, MD

  • Internal Medicine Physician
  • Clyde, OH
  • NPI 1669431938

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1114522919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MAIN AVE STE 121",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141748",
            "telephone_number": "908-627-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST",
            "city": "GREEN SPRINGS",
            "state": "OH",
            "postal_code": "448369653",
            "telephone_number": "419-639-2581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Green Springs",
            "state": "OH",
            "postal_code": "448369734",
            "country_code": "US",
            "telephone_number": "419-639-2581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRING CREEK NURSING AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-639-2581"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corrina Rodd
• Nancy Lee Romans, CDCA
• Amy Michelle Runkle, RN
• Brent Shue
• Amiee Simmons, RN, BSN
• St. Francis Health Care Centre
• Joseph J Supina IV, CDCA, PRS
• Dru Troyer
• Josh Levi Tyree, CDCA, PRS
• Kira Sue Van Der Laar, LISW

• Skilled Nursing Facility in Green Springs, OH
• Providers in Green Springs, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.