NPIMap

Organization Active NPI

East Bay NC, LLC

Doing business as East Bay Rehabilitation Center

  • Skilled Nursing Facility
  • Clearwater, FL
National Provider Identifier
1598752180
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF11340962 Issued in FL
Legal business name
EAST BAY NC, LLC
Doing business as
East Bay Rehabilitation Center
Practice address
4470 E Bay Dr
Clearwater, FL 33764-5772
Phone
(727) 530-7100
Fax
(727) 539-8024
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 SNF11340962 FL Primary

Addresses

Primary practice location

4470 E Bay Dr
Clearwater, FL 33764-5772

Mailing address

4470 E Bay Dr
Clearwater, FL 33764-5772
Phone (727) 530-7100

Other identifiers 2

IdentifierTypeStateIssuer
V516P-6822OtherVA
026453900MedicaidFL

Other names 1

  • East Bay 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
O20031110000203 FL Part A Provider - Skilled Nursing Facility 0345153052 Practice locations: Clearwater, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598752180. Details of each certification follow.

Skilled nursing facility certification: CCN 105697

Legal name
EAST BAY NC LLC
Doing business as
EAST BAY REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jul 26, 1990
Last certification
Feb 15, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Clear Choice Healthcare
Most recent change of ownership
Dec 1, 2003
Organization structure
LLCProprietary
Enrollment address
4470 E Bay Dr
Clearwater, FL 33764-5772
Nursing home name
EAST BAY REHABILITATION CENTER
Affiliated entity
CLEAR CHOICE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
East Bay Rehabilitation CenterCCN 105697 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 26, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120112.0 residents per day on average
Chain
Clear Choice Healthcare8 facilities in the chain

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
10D0683034East Bay Rehabilitation Center4470 E Bay Drive, Clearwater, FL 33764Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

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
Dani Mathew Individual Operational/Managerial Control Feb 17, 2022
Adp of the SNF Jan 29, 2025
Deborah P Kennedy Individual Corporate OfficerExecutive VP Dec 1, 2003
Operational/Managerial ControlExecutive VP of SBK Capital Dec 1, 2022
SBK Capital, LLC Organization, Canton, GA LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2003 99%
Clear Choice Health Care LLC Organization, Palm Shores, FL LLC, Management services company, For-profit Operational/Managerial Control Oct 1, 2007
Leslie R Partee Individual Corporate OfficerVP of Finance Dec 1, 2022
Operational/Managerial Control Dec 1, 2022
Nicholas Egnatz Individual Operational/Managerial Control Nov 15, 2022
Adp of the SNF Jan 29, 2025

Owners & managing parties with NPI records 1

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

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 6

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1598752180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 E BAY DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337645772",
            "telephone_number": "727-530-7100",
            "fax_number": "727-539-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 E BAY DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337645772",
            "telephone_number": "727-530-7100",
            "fax_number": "727-539-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY NC, 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": "SNF11340962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V516P-6822",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026453900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bay Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.