SUNBRIDGE REGENCY - TENNESSEE LLC (NPI# 1881641389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881641389 |
| Entity Type | Organization |
| Organization Name | SUNBRIDGE REGENCY - TENNESSEE LLC |
| Other Organization Name | CUMBERLAND VILLAGE CENTER |
| Practice Address |
136 Davis Lane La Follette TN 37766-3118 |
| Mailing Address |
101 Sun Ave Ne Compliance Department Albuquerque NM 87109-4373 |
| Practice Telephone | 4235620760 |
| Practice Fax Number | 4235626709 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | THOMAS DIVITTORIO (PRESIDENT DIRECTOR) |
| Authorized Official Telephone | 5058213355 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUNBRIDGE HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 00000019 | TN | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 00000019 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0445276 | 05 | |
| TN | BLUE CROSS/BLUE SHIELD OF | 000155310 | 01 |
| CARITEN | 702021736 | 01 | |
| TN | 7440435 | 05 |
| Other Name | Type Code |
|---|---|
| Cumberland Village Center | Former Legal Business Name - Organization |
| Street Address |
136 DAVIS LANE |
| City | LA FOLLETTE |
| State | TN |
| Zip Code | 37766-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104283332 | Amanda Robinosn | Occupational Therapy Assistant | 136 Davis Lane, La Follette, TN 37766 | 2016-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819914 | Legal Medicine | Nurse Practitioner | 100 South 5th Street, Lafollette, TN 37766 | 2019-03-04 |
| 1306329818 | Kayla Ward | Nurse Practitioner | 617 E Central Ave, La Follette, TN 37766 | 2018-09-11 |
| 1740588920 | Campbell County Walk In Clinic LLC | Family Medicine | 2301 Jacksboro Pkie, Lafollette, TN 37766 | 2011-03-11 |
| 1992001853 | Complete Rural Healthcare and Medical Center Pllc | Specialist | 2146 Jacksboro Pike Suite C, Lafollette, TN 37766 | 2011-02-09 |
| 1821211582 | Bill R Fannon Jr. | Pharmacist | 502 West Central Ave, La Follette, TN 37766 | 2007-04-11 |
| 1437272606 | Kelly B Wells | Pharmacist | 502 West Central Avenue, La Follette, TN 37766 | 2007-04-10 |
| 1548386899 | Gerald A Troutman | Dentist | 109 East Beech Street, Lafollette, TN 37766 | 2007-03-21 |
| 1437280815 | Susan Rebecca Mills | Nurse Practitioner | 2221 Jacksboro Pike Ste C4, La Follette, TN 37766 | 2007-03-08 |
| 1699844399 | County of Campbell | Ambulance | 136 North Massachusetts Ave, Lafollette, TN 37766 | 2006-11-07 |
| 1336230465 | George O'neal Vinsant | Surgery | 919 E. Central Avenue, Suite 201, Lafollette, TN 37766 | 2006-09-27 |
| Find all providers in zip 37766 | ||||
| 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 |
|---|---|---|---|---|
| 1023099447 | Campbell County Hma LLC | Skilled Nursing Facility | 200 Torrey Rd, La Follette, TN 37766-2728 | 2005-11-11 |
| 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 | ||||
| City | LA FOLLETTE |
| Zip Code | 37766 |
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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.