Organization Active NPI

Madison Manor Nursing Home LLC

  • Nursing Facility/Intermediate Care Facility
  • Madison, AL
National Provider Identifier
1033178504
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
12609 Issued in AL
Legal business name
MADISON MANOR NURSING HOME LLC
Practice address
3891 Sullivan Street
Madison, AL 35758
Phone
(256) 772-9243
Fax
(256) 772-9233
NPI assigned
Mar 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Noel Dunnam
Title
Cfo
Phone
(251) 743-7137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 12609 AL Primary

Addresses

Primary practice location

3891 Sullivan Street
Madison, AL 35758

Mailing address

501 Whetstone Street
Monroeville, AL 36460
Phone (251) 743-3609

Other identifiers 1

IdentifierTypeStateIssuer
4757500SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000604 AL Part A Provider - Skilled Nursing Facility 7810892189 Practice locations: Madison, AL

Skilled nursing facility certification: CCN 015214

Legal name
MADISON MANOR NURSING HOME LLC
Doing business as
MADISON MANOR NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1982
Last certification
Aug 15, 2024
Beds
80
Ownership / control type
Corporation
Multi-facility organization
CROWNE HEALTHCARE LLC
Most recent change of ownership
Nov 1, 2003
Organization structure
LLCProprietary
Incorporated
Sep 11, 2003 in AL
Enrollment address
3891 Sullivan St
Madison, AL 35758-1740
Nursing home name
MADISON MANOR NURSING HOME
Affiliated entity
CROWNE HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Madison Manor Nursing HomeCCN 015214
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8073.6 residents per day on average
Chain
Crowne Health Care18 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0678837Madison Manor Nursing Home3891 Sullivan Street, Madison, AL 35758Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

3891 Sullivan St
Madison, AL 35758
Phone (256) 337-7365

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Crowne Management, LLC Organization, Monroeville, AL LLC Operational/Managerial Control Dec 10, 2009
Jennifer Jones McInnish Family Dynasty Trust #1 Organization, Monroeville, AL 5% Or Greater Indirect Ownership Interest Dec 31, 2016
Richard Bryan Jones Family Dynasty Trust #1 Organization, Monroeville, AL 5% Or Greater Indirect Ownership Interest Dec 31, 2016
John Todd Wilder Individual Corporate Director Dec 1, 2003
Crowne Operations, Inc Organization, Monroeville, AL Corporation 5% Or Greater Direct Ownership Interest Nov 1, 2003
Marcus F. Manning Individual Corporate Director Jun 11, 2015
Felita L. Smith Individual W-2 Managing Employee Nov 1, 2003
Noel Dunnam Individual Corporate OfficerCfo/Secretary Jun 11, 2015
Corporate DirectorCfo/Secretary Jun 11, 2015
Richard B. Jones Individual Corporate OfficerCeo/Vice President Jun 11, 2015
Corporate DirectorCeo/Vice President Dec 1, 2003

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1033178504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WHETSTONE STREET",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "36460",
            "telephone_number": "251-743-3609",
            "fax_number": "251-575-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3891 SULLIVAN STREET",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-772-9243",
            "fax_number": "256-772-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON MANOR NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "DUNNAM",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "251-743-7137"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AL",
            "license": "12609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757500S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.