Arbor Lake Health & Rehab, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ARBOR LAKE HEALTH & REHAB, LLC

Practice address

1365 Gatewood Dr
Auburn, AL 36830-2834

Phone

(334) 826-7200

Fax

(334) 821-7239

NPI assigned

Sep 27, 2022

Last updated

Sep 27, 2022By 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

Matthew Lewis

Title

Administrator/Owner

Phone

(334) 826-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Arbor Lake Health & Rehab Other name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194449843. Details of each certification follow.

• CCN 015452 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 015452

Legal name

ARBOR LAKE HEALTH & REHAB, LLC

Doing business as

SOUTHERN STATES BANK

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 19, 2004

Last certification

Aug 9, 2023

Beds

87

Ownership / control type

Limited Liability Corporation

Multi-facility organization

TRAYLOR PORTER HEALTH MANAGEMENT

Most recent change of ownership

Nov 9, 2022

Organization structure

LLCProprietary

Incorporated

Sep 23, 2022 in AL

Enrollment address

1365 Gatewood Dr
Auburn, AL 36830-2834

Nursing home name

ARBOR LAKE HEALTH AND REHAB

Affiliated entity

TRAYLOR PORTER HEALTHCARE

Listed as

Arbor Lake Health and RehabCCN 015452 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 19, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8777.5 residents per day on average

Chain

Traylor Porter Healthcare5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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, and the practitioner matching its NPPES authorized official.

• Keith Lyle Fuller, D.O.

  • Family Medicine Physician
  • Opelika, AL
  • NPI 1730125527
  NPD (past)
• Sarat Meka, MD

  • Family Medicine Physician
  • Auburn, AL
  • NPI 1952560765
  NPD (past)

Affiliated clinicians 1

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

• Keith Lyle Fuller, D.O.

  • Family Medicine Physician
  • Opelika, AL
  • NPI 1730125527

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1194449843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 GATEWOOD DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302834",
            "telephone_number": "334-826-7200",
            "fax_number": "334-821-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 GATEWOOD DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302834",
            "telephone_number": "334-826-7200",
            "fax_number": "334-821-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR LAKE HEALTH & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "334-826-7200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4758150S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Lake Health & Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carmen A Anglin
• Jessica Rian Williams Anglin, MD
• Answered Prayer Home Care Services of Auburn LLC.
• Logan Drew Aplin
• Ralph L Aquadro III, MD
• Devin Archer
• Mateo Arenas
• Articularis Healthcare Group Inc. (Premier Rheumatology of Alabama)
• Ryley Jo Anne Asbell
• Ashley Jordan (Auburn Wellness Perspective Counseling)

• Skilled Nursing Facility in Auburn, AL
• Providers in Auburn, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.