Clearwater Living, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLEARWATER LIVING, LLC

Doing business as

Clearwater Nursing and Rehabilitation Center

Practice address

620 E Wood St
Clearwater, KS 67026-9757

Phone

(620) 584-2271

NPI assigned

Jul 24, 2019

Last updated

Jul 24, 2019By 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

Mr. William Matthew Novotny

Title

Ceo

Phone

(785) 789-4750

Specialties & licenses 1

Addresses

Other names 1

• Clearwater Nursing and Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376197756. Details of each certification follow.

• CCN 175454 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 175454

Legal name

CLEARWATER LIVING, LLC

Doing business as

CLEARWATER NURSING AND REHAB CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 2, 2002

Last certification

Jun 3, 2024

Beds

69 (55 certified)

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Advena Living

Organization structure

LLCProprietary

Enrollment address

620 E Wood St
Clearwater, KS 67026-9757

Nursing home name

CLEARWATER NURSING & REHABILITATION CENTER

Affiliated entity

ADVENA LIVING COMMUNITIES

Listed as

Clearwater Nursing & Rehabilitation CenterCCN 175454 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 2, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5542.2 residents per day on average

Chain

Advena Living Communities6 facilities in the chain

Special focus status

SFF Candidate

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

4Fines totaling $225,379

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Tamara L McCue, D.O.

  • Family Medicine Physician
  • Wellington, KS
  • NPI 1457339137

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• Orchard Gardens, LLC

  dba Advena Living on Woodlawn

  • Pediatric Skilled Nursing Facility
  • Wichita, KS
  • NPI 1326504028

  Cghii Inc, Cornerstone Group Holdings Inc

  CMS 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.

• Denis D Knight, DO

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1235190919
  NPD (past)
• Tamara L McCue, D.O.

  • Family Medicine Physician
  • Wellington, KS
  • NPI 1457339137
  NPD (past)

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1376197756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 HYLTON HEIGHTS RD STE 129",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022812",
            "telephone_number": "785-789-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E WOOD ST",
            "city": "CLEARWATER",
            "state": "KS",
            "postal_code": "670269757",
            "telephone_number": "620-584-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "NOVOTNY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-789-4750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy Jean Booker, PT
• Sarah Brown, PHARM D.
• City of Clearwater
• Clearwater Al Opco, LLC (Clearwater Village/Harbor Home)
• Clearwater Family Practice PA
• Clearwater Retirement Community Inc. (CRC The Manor)
• Cindy Davidson, SLP
• Charisse C Frisch, DDS
• Gracemed Health Clinic, Inc (GraceMed Clearwater Family Clinic)
• Richard Grizzle, EMT

• Skilled Nursing Facility in Clearwater, KS
• Providers in Clearwater, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.