NPIMap

Organization Active NPI

Belleair East HCC, LLC

Doing business as Belleair Health Care Center

  • Skilled Nursing Facility
  • Clearwater, FL
National Provider Identifier
1891782488
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF10480962 Issued in FL
Legal business name
BELLEAIR EAST HCC, LLC
Doing business as
Belleair Health Care Center
Practice address
1150 Ponce de Leon Blvd
Clearwater, FL 33756-1041
Phone
(727) 585-5491
Fax
(727) 584-5893
NPI assigned
Sep 29, 2005
Last updated
Oct 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 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 SNF10480962 FL Primary

Addresses

Primary practice location

1150 Ponce de Leon Blvd
Clearwater, FL 33756-1041

Mailing address

1150 Ponce de Leon Blvd
Clearwater, FL 33756-1041
Phone (727) 585-5491

Other identifiers 2

IdentifierTypeStateIssuer
V516P-6819OtherVA
026452100MedicaidFL

Other names 1

  • Belleair Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000249 FL Part A Provider - Skilled Nursing Facility 8527971209 Practice locations: Clearwater, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891782488. Details of each certification follow.

Skilled nursing facility certification: CCN 105636

Legal name
BELLEAIR EAST HCC, LLC
Doing business as
BELLEAIR HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1988
Last certification
Oct 5, 2023
Beds
120
Ownership / control type
Partnership
Organization structure
LLCProprietary
Enrollment address
1150 Ponce de Leon Blvd
Clearwater, FL 33756-1041
Nursing home name
BELLEAIR HEALTH CARE CENTER
Affiliated entity
CLEAR CHOICE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Belleair Health Care CenterCCN 105636 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Dec 1, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120111.7 residents per day on average
Chain
Clear Choice Healthcare8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Belleair East HCC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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 8

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

NameRoleSinceShare
Capital Funding Group, LLC Organization, Baltimore, MD LLC, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Apr 9, 2019 65.1%
Deborah P Kennedy Individual Operational/Managerial Control Dec 1, 2022
Adp of the SNF Dec 1, 2022
SBK Capital, LLC Organization, Canton, GA LLC Direct Ownership Interest Dec 1, 2003 99%
Mouna Bacha Individual Operational/Managerial Control Nov 29, 2017
Adp of the SNF Nov 21, 2025
Clear Choice Health Care LLC Organization, Melbourne, FL LLC, For-profit Operational/Managerial Control Oct 1, 2007
Leslie R Partee Individual Corporate OfficerVice President of Finance Dec 1, 2003
Operational/Managerial Control Dec 1, 2022
Grant L Buckner Individual Operational/Managerial Control Apr 7, 2025
Adp of the SNF Nov 21, 2025
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 9

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": "1255910400000",
    "number": "1891782488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PONCE DE LEON BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337561041",
            "telephone_number": "727-585-5491",
            "fax_number": "727-584-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PONCE DE LEON BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337561041",
            "telephone_number": "727-585-5491",
            "fax_number": "727-584-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEAIR EAST HCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-10-19",
        "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": "SNF10480962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V516P-6819",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026452100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Belleair Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.