NPIMap

Organization Active NPI

Spruce LTC Group, LLC

  • Skilled Nursing Facility
  • Mint Hill, NC
National Provider Identifier
1710312079
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SPRUCE LTC GROUP, LLC
Practice address
10506 Clear Creek Commerce Dr
Mint Hill, NC 28227-7078
Phone
(704) 545-2377
Fax
(252) 939-4254
NPI assigned
Sep 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Gale Boice
Title
Cfo
Phone
(252) 523-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10506 Clear Creek Commerce Dr
Mint Hill, NC 28227-7078

Mailing address

PO Box 6249
Kinston, NC 28501-0249
Phone (252) 523-9094

Other identifiers 1

IdentifierTypeStateIssuer
NH0635OtherNCNURSING HOME LICENSE

Other names 1

  • Clear Creek Nursing and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130926000647 NC Part A Provider - Skilled Nursing Facility 7416138516 Practice locations: Mint Hill, NC

Skilled nursing facility certification: CCN 345562

Legal name
SPRUCE LTC GROUP, LLC
Doing business as
CLEAR CREEK NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 7, 2013
Last certification
Mar 21, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Spruce LTC, LLC
Organization structure
LLCProprietary
Incorporated
Aug 20, 2010 in NC
Enrollment address
10506 Clear Creek Commerce Dr
Mint Hill, NC 28227-7078
Nursing home name
CLEAR CREEK NURSING & REHABILITATION CENTER
Affiliated entity
PRINCIPLE LONG TERM CARE

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clear Creek Nursing & Rehabilitation CenterCCN 345562
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 7, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120111.7 residents per day on average
Chain
Principle Long Term Care40 facilities in the chain
Penalties (3 years)
3Fines totaling $105,396

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
34D2061991Clear Creek Nursing and Rehabilitation10506 Clear Creek Commerce Drive, Mint Hill, NC 28227Certificate of waiverJan 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ability Network5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Raymond Gregg Hill Individual 5% Or Greater Direct Ownership InterestOwner/Board Member Jan 1, 2011 18.47%
Adp of the SNF Jan 1, 2011
Direct Ownership Interest Jan 1, 2011 18.47%
Robert O'Neil Hill Individual 5% Or Greater Direct Ownership InterestOwner/Board Member Jan 1, 2011 20.6%
Adp of the SNF Jan 1, 2011
Direct Ownership Interest Jan 1, 2011 20.6%
Stephen Britt Hill Individual 5% Or Greater Direct Ownership InterestOwner/Board Member Jan 1, 2011 20.02%
Adp of the SNF Jan 1, 2011
Direct Ownership Interest Jan 1, 2011 20.02%
Gale R Boice Individual Corporate OfficerCfo Mar 5, 2018
Adp of the SNF Mar 5, 2018
Dianne Johnson Individual Corporate OfficerTreasurer Sep 19, 2013 5%
Principle Long Term Care, Inc. Organization, Kinston, NC Management services company, Chain home office 5% Or Greater Direct Ownership Interest Sep 19, 2013 50%
Operational/Managerial Control Jan 1, 2011 100%
Adp of the SNF Apr 9, 2025
William J Long Individual Managing Control - Governing Body Jan 1, 2025
Adp of the SNF May 16, 2025
Principle It Services, Inc. Organization, Kinston, NC LLC 5% Or Greater Direct Ownership Interest Sep 19, 2013 50%
Robert Johnson Individual Operational/Managerial Control Jan 15, 2025
Adp of the SNF Jun 13, 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 43

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

View all 43

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1710312079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6249",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285010249",
            "telephone_number": "252-523-9094",
            "fax_number": "252-939-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 CLEAR CREEK COMMERCE DR",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282277078",
            "telephone_number": "704-545-2377",
            "fax_number": "252-939-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE LTC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "BOICE",
        "authorized_official_first_name": "GALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "252-523-9094"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING HOME LICENSE",
            "identifier": "NH0635",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clear Creek Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clear Creek Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mint Hill, NC

Sources for this page

Verify at the official NPI Registry.