Organization Active NPI

Wadley SNF Operator LLC

Doing business as Comfort Creek Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Wadley, GA
National Provider Identifier
1255815304
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WADLEY SNF OPERATOR LLC
Doing business as
Comfort Creek Nursing and Rehabilitation Center
Practice address
10200 US Highway 1 S
Wadley, GA 30477-3864
Phone
(478) 252-5254
Fax
(478) 252-1750
NPI assigned
Sep 24, 2018
Last updated
May 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Bruce E Wertheim
Title
Manager
Phone
(813) 347-9888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

10200 US Highway 1 S
Wadley, GA 30477-3864

Mailing address

10200 US Highway 1 S
Wadley, GA 30477-3864
Phone (478) 252-5254

Other names 1

  • Comfort Creek Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181213002124 GA Part A Provider - Skilled Nursing Facility 4789929167 Practice locations: Wadley, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255815304. Details of each certification follow.

Skilled nursing facility certification: CCN 115679

Legal name
WADLEY SNF OPERATOR LLC
Doing business as
COMFORT CREEK NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 2002
Last certification
Apr 17, 2025
Beds
98
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Beacon Healthcare Management LLC
Organization structure
LLCProprietary
Incorporated
Sep 12, 2018 in FL
Enrollment address
10200 US Highway 1 S
Wadley, GA 30477-3864
Nursing home name
COMFORT CREEK NURSING AND REHABILITATION CENTER
Affiliated entity
BEACON HEALTH MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Comfort Creek Nursing and Rehabilitation CenterCCN 115679 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9869.2 residents per day on average
Chain
Beacon Health Management11 facilities in the chain
Penalties (3 years)
1Fines totaling $15,880

Processed by Care Compare on Aug 1, 2026.

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
11D2054524Comfort Creek Nursing and Rehab Center10200 US Highway 1 South, Wadley, GA 30477Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Bruce E Wertheim Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2018 100%
Corporate OfficerManager Dec 1, 2018
Operational/Managerial ControlManager Dec 1, 2018 100%
HSP Southern Healthcare LLC Organization, Tampa, FL LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2018 100%
Lynette D McDowell Individual W-2 Managing EmployeeAdministrator Dec 1, 2018 100%
Beacon Health Management LLC Organization, Tampa, FL LLC, Management services company, For-profit Operational/Managerial Control Dec 1, 2018 100%

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 1

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 1

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": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1255815304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 US HIGHWAY 1 S",
            "city": "WADLEY",
            "state": "GA",
            "postal_code": "304773864",
            "telephone_number": "478-252-5254",
            "fax_number": "478-252-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 US HIGHWAY 1 S",
            "city": "WADLEY",
            "state": "GA",
            "postal_code": "304773864",
            "telephone_number": "478-252-5254",
            "fax_number": "478-252-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADLEY SNF OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "WERTHEIM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-347-9888"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Creek Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wadley, GA

Sources for this page

Verify at the official NPI Registry.