Clear Lake Rehabilitation Hospital, LLC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

008335 Issued in TX

Legal business name

CLEAR LAKE REHABILITATION HOSPITAL, LLC

Doing business as

Kindred Rehabilitation Hospital Clear Lake

Practice address

655 E Medical Center Blvd
Webster, TX 77598-4328

Phone

(281) 286-1500

NPI assigned

Jun 1, 2006

Last updated

May 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terrance K. Dillon

Title

Assistant Secretary

Phone

(502) 596-7220

Specialties & licenses 1

Addresses

Other names 1

• Kindred Rehabilitation Hospital Clear Lake Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972540417. Details of each certification follow.

• CCN 453052 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 453052

Legal name

KINDRED REHABILITATION HOSPITAL CLEAR LAKE

Certification status

Terminated Voluntary: merger or closure, Aug 1, 2019

Provider type (POS)

Hospital – Rehabilitation

Participating since

Oct 16, 1991

Last certification

Jun 12, 2019

Beds

60

Ownership / control type

Private (for profit)

Most recent change of ownership

Aug 1, 2005 (1 total)

Facility address

655 E Medical Center Blvd
Webster, TX 77598

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Rehabcare Group East LLC

  dba RehabCare

  • Rehabilitation Clinic/Center
  • Jefferson City, MO
  • NPI 1972020394

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1972540417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984328",
            "telephone_number": "281-286-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "TX",
            "license": "008335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Rehabilitation Hospital Clear Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Rehabilitation Hospital Clear Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clear Lake Pediatric Clinic, P.a.
• Clear Lake Pediatric Nephrology, P.a.
• Clear Lake Physicians, PLLC
• Clear Lake Podiatry PLLC
• Clear Lake Primary Care PLLC
• Clear Lake Surgicare, LTD (Bay Area Surgicare Center)
• Clear Lake Urology
• Clear Lake Vascular Access Associates Series, PLLC
• Clear Lake Webster Medical Center LLC
• Clear Lake Wound Care PLLC

• Rehabilitation Hospital in Webster, TX
• Providers in Webster, TX by specialty
• Rehabilitation Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.