CLC OF DYERSBURG, LLC (NPI# 1508856295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508856295 |
| Entity Type | Organization |
| Organization Name | CLC OF DYERSBURG, LLC |
| Other Organization Name | OAKWOOD COMMUNITY LIVING CENTER |
| Practice Address |
1636 Woodlawn Ave Dyersburg TN 38024-2026 |
| Practice Telephone | 7312856400 |
| Practice Fax Number | 7312859017 |
| Mailing Telephone | 7312856400 |
| Mailing Fax Number | 7312859017 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER) |
| Authorized Official Telephone | 6626803148 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0000000075 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 744-0153 | 05 |
| Other Name | Type Code |
|---|---|
| Oakwood Community Living Center | Doing Business As Name - Organization |
| Street Address |
1636 WOODLAWN AVE |
| City | DYERSBURG |
| State | TN |
| Zip Code | 38024-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215409925 | John Lamar Campbell II | Physical Therapy Assistant | 1636 Woodlawn Ave, Dyersburg, TN 38024-2026 | 2018-12-19 |
| 1801380688 | Stephanie Andrews | Physical Therapist | 1636 Woodlawn Ave, Dyersburg, TN 38024-2026 | 2018-06-15 |
| 1346796596 | Cara Hassell | Occupational Therapist | 1636 Woodlawn Ave, Dyersburg, TN 38024 | 2016-08-28 |
| 1073885182 | Gracie M Griffith | Physical Therapy Assistant | 1636 Woodlawn Ave, Dyersburg, TN 38024-2026 | 2012-02-04 |
| 1265689012 | Georgia Barnes Day | Physical Therapy Assistant | 1636 Woodlawn Ave, Dyersburg, TN 38024-2026 | 2008-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760273 | Alison Clement | Nurse Practitioner | 750 W Highway 51 Bypass, Dyersburg, TN 38024 | 2020-01-29 |
| 1861030652 | Pagela Jobe | Nurse Practitioner | 750 West Highway 51 Bypass, Dyersburg, TN 38024 | 2019-12-12 |
| 1083184055 | Whitney Young | Nurse Practitioner | 455 East Parkview, Dyersburg, TN 38024 | 2018-12-03 |
| 1518434067 | Myeyedr Optometry of Tennessee, LLC | Optometrist | 400 Us Hwy 51 S, Dyersburg, TN 38024 | 2018-11-01 |
| 1225529142 | Kidney Experts Pllc | Internal Medicine | 1575 Parr Ave # B, Dyersburg, TN 38024 | 2018-05-25 |
| 1407344690 | Darnisha Williams | Pharmacist | 2650 Lake Road, Dyersburg, TN 38024 | 2018-04-24 |
| 1376081547 | Chasidy Branch | Counselor | 640 U.S. Highway 51 Bypass E. Suite M, Dyersburg, TN 38024 | 2017-02-07 |
| 1548671845 | Shree Ramakant Mulay | Internal Medicine | 1575 Parr Ave Ste B, Dyersburg, TN 38024 | 2014-05-08 |
| 1588904965 | Selina Carol Purvis | Physical Therapy Assistant | 1900 Parr Avenue, Dyersburg, TN 38024 | 2013-02-22 |
| 1326396029 | Tennessee Sleep Managment LLC | Clinic/Center | 1190 Hwy 51 By-pass West, Suite C, Dyersburg, TN 38024 | 2012-08-28 |
| Find all providers in zip 38024 | ||||
| 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 |
|---|---|---|---|---|
| 1871058883 | Tn Dyer Op LLC | Skilled Nursing Facility | 350 E Tickle St, Dyersburg, TN 38024-3118 | 2019-02-04 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.