Organization Active NPI

LTC of Fall Creek LLC

  • Skilled Nursing Facility
  • Humble, TX
National Provider Identifier
1851743637
Registry record updated Dec 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LTC OF FALL CREEK LLC
Practice address
14949 Mesa Dr
Humble, TX 77396-2952
Phone
(281) 902-4152
NPI assigned
Jul 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2017

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

Authorized official

Name
Sharlyn Threadgill
Title
President
Phone
(512) 482-8242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X TX Primary

Addresses

Primary practice location

14949 Mesa Dr
Humble, TX 77396-2952

Mailing address

200 Congress Ave
Suite 30a
Austin, TX 78701-4527
Phone (512) 482-8242

Other identifiers 1

IdentifierTypeStateIssuer
001027972MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161003000511 TX Part A Provider - Skilled Nursing Facility 9537456777 Practice locations: Humble, TX

Skilled nursing facility certification: CCN 676412

Legal name
LTC OF FALL CREEK LLC
Doing business as
FALL CREEK REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 13, 2016
Last certification
Mar 7, 2024
Beds
126
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
14949 Mesa Dr
Humble, TX 77396-2952
Nursing home name
FALL CREEK REHABILITATION AND HEALTHCARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fall Creek Rehabilitation and Healthcare CenterCCN 676412 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 13, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12684.2 residents per day on average
Penalties (3 years)
2Fines totaling $48,555

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
45D2120164Fall Creek Rehabilitation and Healthcare Center14949 Mesa Dr, Humble, TX 77396Certificate of waiverOct 10, 2026

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
James Compton Individual 5% Or Greater Mortgage InterestMember Oct 1, 2020 8.33%
Adp of the SNF Oct 1, 2020
Martel Healthcare Management LLC Organization, Austin, TX LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Oct 1, 2020 33.33%
Adp of the SNF Oct 1, 2020
Bullpen Family Venture, LP Organization, Austin, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 12, 2015 100%
Bullpen One, LLC Organization, Meridian, MS LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 12, 2015 10%
Edaws Investment Group, LP Organization, Austin, TX Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 12, 2015 90%
The Smithers Management Trust Organization, Austin, TX 5% Or Greater Mortgage Interest Oct 1, 2020 33.34%
Adp of the SNF Oct 1, 2020
Michael G Reed Individual 5% Or Greater Indirect Ownership InterestMember Dec 12, 2015 50%
Compton3 Holdings, LLC Organization, Austin, TX LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Oct 1, 2020 33.33%
Adp of the SNF Oct 1, 2020
Kris Compton Individual 5% Or Greater Mortgage InterestMember Oct 1, 2020 8.33%
Adp of the SNF Oct 1, 2020
Charles Compton Individual 5% Or Greater Mortgage InterestMember Oct 1, 2020 8.33%
Adp of the SNF Oct 1, 2020
Stacie W Reed Individual 5% Or Greater Indirect Ownership InterestMember Dec 12, 2015 50%
Clearlake Healthcare Realty, LLC Organization, Austin, TX LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Oct 1, 2020 100%
Adp of the SNF Oct 1, 2020
Rachel M Suter Individual Operational/Managerial Control Jun 27, 2016
Adp of the SNF Jun 27, 2016
Forrest Threadgill Individual 5% Or Greater Indirect Ownership InterestMember Oct 1, 2020 10%
Sharlyn Threadgill Individual 5% Or Greater Indirect Ownership InterestMember Oct 1, 2020 78%
Operational/Managerial Control Oct 1, 2020
Julia Lanier Individual Adp of the SNF Jun 12, 2018
Morgan Threadgill Individual 5% Or Greater Indirect Ownership InterestMember Oct 1, 2020 10%
Michael Martel Individual 5% Or Greater Mortgage InterestMember Oct 1, 2020 33.33%
Adp of the SNF Oct 1, 2020
James Compton Individual 5% Or Greater Mortgage InterestMember Oct 1, 2020 8.33%
Adp of the SNF Oct 1, 2020

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513468800000",
    "number": "1851743637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CONGRESS AVE",
            "address_2": "SUITE 30A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787014527",
            "telephone_number": "512-482-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 MESA DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962952",
            "telephone_number": "281-902-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC OF FALL CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2017-12-17",
        "status": "A",
        "authorized_official_last_name": "THREADGILL",
        "authorized_official_first_name": "SHARLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-482-8242"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027972",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.