Andersonville TN Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ANDERSONVILLE TN OPCO, LLC

Practice address

3382 Andersonville Hwy
Andersonville, TN 37705-3816

Phone

(773) 870-7818

NPI assigned

Apr 20, 2022

Last updated

Feb 7, 2023By 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

David Rubinstein

Title

Chief Financial Officer

Phone

(212) 444-1991

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083357628. Details of each certification follow.

• CCN 445303 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445303

Legal name

ANDERSONVILLE TN OPCO, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1992

Last certification

Apr 20, 2022

Beds

103

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Plainview Healthcare

Organization structure

LLCProprietary

Incorporated

Apr 7, 2022 in DE

Enrollment address

3382 Andersonville Hwy
Andersonville, TN 37705-3816

Nursing home name

ANDERSONVILLE TN OPCO LLC

Affiliated entity

PLAINVIEW HEALTHCARE PARTNERS

Listed as

Andersonville TN Opco LLCCCN 445303 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Dec 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10390.9 residents per day on average

Chain

Plainview Healthcare Partners9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 7

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Anton Christopher Daniel, MD

  • Internal Medicine Physician
  • Newport, TN
  • NPI 1700856135

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anton Christopher Daniel, MD

  • Internal Medicine Physician
  • Newport, TN
  • NPI 1700856135
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Anton Christopher Daniel, MD

  • Internal Medicine Physician
  • Newport, TN
  • NPI 1700856135

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1083357628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23645 MERCANTILE RD STE J",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225936",
            "telephone_number": "646-649-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3382 ANDERSONVILLE HWY",
            "city": "ANDERSONVILLE",
            "state": "TN",
            "postal_code": "377053816",
            "telephone_number": "773-870-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSONVILLE TN OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "RUBINSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-444-1991"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andersonville TN Holdco LLC
• Kandi Bailey, RN
• Jessica Leanne Balzer, LCSW
• Divinity Health Diagnostics,LLC
• Keri Powell Galloway, PHARMD
• Natalie Hamel, RBT

• Skilled Nursing Facility in Andersonville, TN
• Providers in Andersonville, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.