Organization Active NPI

Clearsky Rehabilitation Hospital of Flower Mound LLC

  • Rehabilitation Hospital
  • Flower Mound, TX
National Provider Identifier
1407467855
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CLEARSKY REHABILITATION HOSPITAL OF FLOWER MOUND LLC
Practice address
3100 Peters Colony Rd
Flower Mound, TX 75022-2949
Phone
(512) 995-7597
NPI assigned
Aug 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Kristi Duncan
Title
Cfo
Phone
(505) 270-9795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

3100 Peters Colony Rd
Flower Mound, TX 75022-2949

Mailing address

5600 Wyoming Blvd NE Ste 225
Albuquerque, NM 87109-3136
Phone (505) 317-3802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200825000917 TX Part A Provider - Hospital 4981021763 Practice locations: Flower Mound, TX

Hospital certification: CCN 673076

Legal name
CLEARSKY REHABILITATION HOSPITAL OF FLOWER MOUND LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Feb 5, 2021
Last certification
Feb 5, 2021
Beds
41
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Aug 3, 2020 in DE
Enrollment address
3100 Peters Colony Rd
Flower Mound, TX 75022-2949
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Clearsky Rehabilitation Hospital of Flower MoundCCN 673076
Ownership
For profit
Certified
Feb 5, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
BW Clearsky Aiv IV C Corp Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Nov 17, 2023 9.45%
BW Clearsky Aiv IV Indirect Feeder LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Nov 17, 2023 9.45%
BW Aiv IV Direct Feeder LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 35.21%
Peloton Clearsky Inc Organization, Greenwich, CT Corporation 5% Or Greater Indirect Ownership Interest Nov 17, 2023 44.66%
Kristi L Duncan Individual Corporate OfficerCfo Aug 3, 2020
Peloton Clearsky LLC Organization, Greenwich, CT LLC 5% Or Greater Indirect Ownership Interest Nov 17, 2023 22.33%
Peloton Equity II LP Organization, Greenwich, CT 5% Or Greater Indirect Ownership Interest Nov 17, 2023 22.33%
Claude Darby Brockette Individual Corporate OfficerPresident Aug 3, 2020
Sheryl H Gentile Individual Corporate OfficerVice President Aug 3, 2020
Clearsky Health Acquisition LLC Organization, Albuquerque, NM LLC 5% Or Greater Direct Ownership Interest Aug 3, 2020 100%
Leavitt Equity Partners II LP Organization, Salt Lake City, UT 5% Or Greater Indirect Ownership Interest Nov 17, 2023 5.95%
Michael J Warrington Individual Corporate OfficerPresident Dec 2, 2024
Clearsky Health Intermediate LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Aug 3, 2020 100%
Clearsky Employee Holdings-a, LLC Organization, New York, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 17, 2023 4.74%
Tracie Watkins Individual W-2 Managing EmployeeHospital Ceo Dec 4, 2023
Clearsky Health Holdings LLC Organization, Albuquerque, NM LLC 5% Or Greater Indirect Ownership Interest Aug 3, 2020 100%
Theodore B Lundberg Individual Corporate Officer Aug 3, 2020
Jeremy Michael Kogler Individual Corporate OfficerVice President Aug 3, 2020
BW Clearsky Aiv IV LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Nov 17, 2023 44.66%

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 3

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": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1407467855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 WYOMING BLVD NE STE 225",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093136",
            "telephone_number": "505-317-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PETERS COLONY RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222949",
            "telephone_number": "512-995-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARSKY REHABILITATION HOSPITAL OF FLOWER MOUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "505-270-9795"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.