NPIMap

Organization Active NPI

Melbourne Terrace RCC, LLC

Doing business as Melbourne Terrace Rehabilitation Center

  • Skilled Nursing Facility
  • Melbourne, FL
National Provider Identifier
1376530956
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF13400962 Issued in FL
Legal business name
MELBOURNE TERRACE RCC, LLC
Doing business as
Melbourne Terrace Rehabilitation Center
Practice address
251 E Florida Ave
Melbourne, FL 32901-8303
Phone
(321) 725-3990
Fax
(321) 725-4099
NPI assigned
Sep 29, 2005
Last updated
Jan 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Mr. Samuel B Kellett
Title
As Sole Member of SBK Capital LLC
Phone
(404) 233-7048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF13400962 FL Primary

Addresses

Primary practice location

251 E Florida Ave
Melbourne, FL 32901-8303

Mailing address

251 E Florida Ave
Melbourne, FL 32901-8303
Phone (321) 725-3990

Other identifiers 2

IdentifierTypeStateIssuer
026454700MedicaidFL
V673P-5337OtherVA

Other names 1

  • Melbourne Terrace Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000190 FL Part A Provider - Skilled Nursing Facility 3274446984 Practice locations: Melbourne, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376530956. Details of each certification follow.

Skilled nursing facility certification: CCN 105635

Legal name
MELBOURNE TERRACE RCC, LLC
Doing business as
MELBOURNE TERRACE REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 9, 1989
Last certification
Dec 5, 2024
Beds
179
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Clear Choice Health Care
Most recent change of ownership
Dec 1, 2003
Organization structure
LLCProprietary
Enrollment address
251 Florida Ave
Melbourne, FL 32901-8303
Nursing home name
MELBOURNE TERRACE REHABILITATION CENTER
Affiliated entity
CLEAR CHOICE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Melbourne Terrace Rehabilitation CenterCCN 105635 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 9, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
179168.5 residents per day on average
Chain
Clear Choice Healthcare8 facilities in the chain
Penalties (3 years)
2Fines totaling $15,646

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
10D0667876Melbourne Terrace Rehabilitation Center251 Florida Avenue, Melbourne, FL 32901Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

251 E Florida Ave
Melbourne, FL 32901
Phone (321) 725-3900

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

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.

NameRoleSinceShare
Tina Cone Individual W-2 Managing EmployeeAdministrator Dec 2, 2019
Deborah P Kennedy Individual Operational/Managerial ControlExecutive VP of SBK Capital, LLC Dec 1, 2003
Other Dec 1, 2003
SBK Capital, LLC Organization, Atlanta, GA LLC 5% Or Greater Direct Ownership Interest Dec 1, 2003 99%
Capital One NA Organization, New Orleans, LA Corporation, Financial institution 5% Or Greater Mortgage Interest Apr 5, 2019
Clear Choice Health Care LLC Organization, Melbourne, FL LLC, Management services company Operational/Managerial Control Oct 1, 2007
Leslie R Partee Individual Corporate OfficerVP of Finance Oct 1, 2007
W-2 Managing EmployeeVice President of Finance Dec 1, 2022
Operational/Managerial Control Jan 2, 2025

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1376530956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E FLORIDA AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018303",
            "telephone_number": "321-725-3990",
            "fax_number": "321-725-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E FLORIDA AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018303",
            "telephone_number": "321-725-3990",
            "fax_number": "321-725-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELBOURNE TERRACE RCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "KELLETT",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "AS SOLE MEMBER OF SBK CAPITAL LLC",
        "authorized_official_telephone_number": "404-233-7048",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF13400962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026454700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V673P-5337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melbourne Terrace Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.