NPIMap

Organization Active NPI

Deep Creek RNC, LLC

  • Skilled Nursing Facility
  • Port Charlotte, FL
National Provider Identifier
1679560262
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF14260961 Issued in FL
Legal business name
DEEP CREEK RNC, LLC
Practice address
25325 Rampart Blvd
Port Charlotte, FL 33983
Phone
(941) 629-7466
Fax
(941) 629-9053
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Leslie R Partee
Title
Vice President of Finance
Phone
(404) 406-4150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF14260961 FL Primary

Addresses

Primary practice location

25325 Rampart Blvd
Port Charlotte, FL 33983

Mailing address

25325 Rampart Blvd
Port Charlotte, FL 33983-6404
Phone (941) 629-7466

Other identifiers 2

IdentifierTypeStateIssuer
V516P-6820OtherVA
0319325 00MedicaidFL

Other names 1

  • Port Charlotte 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
O20031110000053 FL Part A Provider - Skilled Nursing Facility 7810800596 Practice locations: Port Charlotte, FL

Skilled nursing facility certification: CCN 105524

Legal name
DEEP CREEK RNC, LLC
Doing business as
PORT CHARLOTTE REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 25, 1985
Last certification
Dec 19, 2024
Beds
152
Ownership / control type
Partnership
Most recent change of ownership
Dec 1, 2003
Organization structure
LLCProprietary
Enrollment address
25325 Rampart Blvd
Port Charlotte, FL 33983-6404
Nursing home name
PORT CHARLOTTE REHABILITATION CENTER
Affiliated entity
CLEAR CHOICE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Port Charlotte Rehabilitation CenterCCN 105524
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Sep 25, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
152147.3 residents per day on average
Chain
Clear Choice Healthcare8 facilities in the chain
Penalties (3 years)
1Fines totaling $45,920

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
10D0294809Port Charlotte Rehabilitation Center25325 Rampart Blvd, Port Charlotte, FL 33983Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Networks

  • 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)
  • 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 Maximo (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)…

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Arturo Rodriguez Martin Individual Operational/Managerial Control Nov 27, 2017
Adp of the SNF Dec 11, 2025
Capital Funding Group, LLC Organization, Baltimore, MD LLC, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Feb 14, 2022 66.6%
Deborah P Kennedy Individual Corporate OfficerExecutive VP Dec 1, 2003
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, For-profit Operational/Managerial Control Oct 1, 2007
Matthew B Lessig Individual Operational/Managerial Control Jun 17, 2023
Adp of the SNF Dec 11, 2025
Leslie R Partee Individual Corporate OfficerVP of Finance Dec 1, 2022
Samuel B Kellet Qtip MRTL TR Organization, Canton, GA LLC, For-profit Direct Ownership Interest Dec 1, 2003 1%

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 27

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

View all 27

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": "1736899200000",
    "number": "1679560262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25325 RAMPART BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339836404",
            "telephone_number": "941-629-7466",
            "fax_number": "941-629-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25325 RAMPART BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33983",
            "telephone_number": "941-629-7466",
            "fax_number": "941-629-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP CREEK RNC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "PARTEE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "404-406-4150"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF14260961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V516P-6820",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0319325 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Charlotte Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Charlotte Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.