TENNESSEE STATE VETERANS HOME BOARD (NPI# 1093708943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093708943 |
| Entity Type | Organization |
| Organization Name | TENNESSEE STATE VETERANS HOME BOARD |
| Practice Address |
2865 E Main St Humboldt TN 38343-3070 |
| Mailing Address |
P.o. Box 11328 Murfreesboro TN 37129 |
| Practice Telephone | 7317848405 |
| Practice Fax Number | 7317842448 |
| Mailing Telephone | 6152251816 |
| Mailing Fax Number | 6158981181 |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2014-04-07 |
| Authorized Official Name | MRS. MARY ROSS (CHAIRMAN) |
| Authorized Official Telephone | 6152251816 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 0000000346 | TN | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 0000000346 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 7440578 | 05 | |
| TN | BLUECROSS BLUESHIELD | 3030638 | 01 |
| TN | 0445366 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528448974 | Tennessee State Veterans Home Board | Skilled Nursing Facility | 250 Arrowood Drive, Clarksville, TN 37042 | 2015-06-01 |
| 1790726503 | Tennessee State Veterans Home Board | Skilled Nursing Facility | One Veterans Way, Knoxville, TN 37931-3101 | 2006-06-10 |
| 1225021348 | Tennessee State Veterans Home Board | Skilled Nursing Facility | 345 Compton Road, Murfreesboro, TN 37130-1352 | 2005-08-24 |
| Street Address |
2865 E MAIN ST |
| City | HUMBOLDT |
| State | TN |
| Zip Code | 38343-3070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891312385 | Brooklyn Victoria Morris | Occupational Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2020-06-30 |
| 1588283212 | Alexandria M Blakemore | Speech-Language Pathologist | 2865 E Main St, Humboldt, TN 38343-3070 | 2020-04-13 |
| 1023644747 | Justin Perry | Physical Therapy Assistant | 2865 E Main St, Humboldt, TN 38343 | 2020-03-13 |
| 1003440678 | Zackary Austin | Physical Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2020-02-23 |
| 1144787110 | Carlye J Martin | Occupational Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2019-02-26 |
| 1528522265 | Jeff Orgain | Occupational Therapist | 2865 E Main St, Humboldt, TN 38343-3070 | 2019-01-28 |
| 1316401912 | Mary Elizabeth Via | Speech-Language Pathologist | 2865 E Main St, Humboldt, TN 38343-3070 | 2019-01-28 |
| 1972067619 | Jonathan Dale James | Physical Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2019-01-28 |
| 1275009920 | Jessica Torres | Physical Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2018-10-21 |
| 1346426483 | Dorothy L Michaud | Physical Therapy Assistant | 2865 E Main St, Humboldt, TN 38343-3070 | 2008-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1942774336 | Lisa Danielle Taylor | Occupational Therapy Assistant | 3513 Chere Carol Rd., Humboldt, TN 38343 | 2019-01-18 |
| 1336633916 | Rachel Mccarley | Physical Therapist | 2400mitchell St, Humboldt, TN 38343 | 2018-06-18 |
| 1346521911 | Barbara Jean Potts | Registered Nurse | 149 12th Street, Humboldt, TN 38343 | 2011-09-08 |
| 1871881920 | Joyce Ama Addo | Physician Assistant | 1804 Main Street, Rainbow Pediatric, Humboldt, TN 38343 | 2011-07-11 |
| 1508161126 | Rhatrenton Mr Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 195 Turner's Loop, Humboldt, TN 38343 | 2011-01-12 |
| 1053616672 | Rha Trenton Mr Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 205 Turner's Loop, Humboldt, TN 38343 | 2011-01-12 |
| 1013219252 | Behavioral Outreach Services, LLC | Community/Behavioral Health | 142 Mason Cemetery Rd, Humboldt, TN 38343 | 2010-11-19 |
| 1528373131 | Edmon Jonh Moreno Hilario | Physical Therapist | 2400 Mitchell Street, Humboldt, TN 38343 | 2010-08-09 |
| 1326376948 | Humboldt Area Rescue Squad/ems | Ambulance | 2707 East End Drive, Humboldt, TN 38343 | 2009-11-19 |
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| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285719989 | Colonial Acres of Humboldt | Skilled Nursing Facility | 1043 10th St, Humboldt, NE 68376-6018 | 2006-10-25 |
| 1154355022 | Florida Senior Housing Council, Inc. | Skilled Nursing Facility | 1020 Pine, Humboldt, KS 66748 | 2006-07-10 |
| 1881624815 | Humboldt Nursing Home, Inc. | Skilled Nursing Facility | 3515 Chere Carol Rd, Humboldt, TN 38343-3638 | 2006-07-04 |
| 1275523854 | Clc of Humboldt, LLC | Skilled Nursing Facility | 2400 E Mitchell St, Humboldt, TN 38343-3036 | 2005-10-25 |
| 1760475487 | Qhc Humboldt South LLC | Skilled Nursing Facility | 800 13th St S, Humboldt, IA 50548-2439 | 2005-08-28 |
| 1851384572 | Qhc Humboldt North LLC | Skilled Nursing Facility | 1111 11th Ave N, Humboldt, IA 50548-1225 | 2005-08-28 |
| 1376849174 | Pinecrest Care Center LLC | Skilled Nursing Facility | 1020 Pine St, Humboldt, KS 66748-1960 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093343535 | Marie Carmelle Noel | Skilled Nursing Facility | 800 Sadie Ann Ct, Smyrna, TN 37167-3445 | 2020-03-30 |
| 1396308508 | Decatur Operating Group LLC | Skilled Nursing Facility | 332 River Rd, Decatur, TN 37322-7800 | 2019-04-15 |
| 1760940613 | Marble City Medical LLC | Skilled Nursing Facility | 7500 Dodson Rd, Knoxville, TN 37920-9734 | 2019-03-11 |
| 1083132641 | Decatur Healthcare, LLC | Skilled Nursing Facility | 322 River Road, Decatur, TN 38322 | 2017-09-05 |
| 1285155705 | Stones River Manor, Inc. | Skilled Nursing Facility | 205 Haynes Dr, Murfreesboro, TN 37129-5101 | 2017-07-06 |
| 1821538562 | Red Bank Operations, LLC | Skilled Nursing Facility | 1020 Runyan Drive, Chattanooga, TN 37405 | 2017-02-28 |
| 1316482458 | East Ridge Snf Operations, LLC | Skilled Nursing Facility | 1502 Mcdonald Rd., East Ridge, TN 37412 | 2016-12-28 |
| 1639625254 | Emerald Spring Hill, Inc. | Skilled Nursing Facility | 2000 Reserve Boulevard, Spring Hill, TN 37174-2370 | 2016-09-01 |
| 1245786482 | Nhc-maury Regional Transitional Care Center LLC | Skilled Nursing Facility | 5010 Trotwood Ave, Columbia, TN 38401-4903 | 2016-08-28 |
| 1457805186 | Barton Blazer Smith | Skilled Nursing Facility | 210 Busbee Rd, Knoxville, TN 37920-5104 | 2016-08-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.