NPIMap

Organization Active NPI

Bordeaux Long Term Care

  • Skilled Nursing Facility
  • Nashville, TN
National Provider Identifier
1083609168
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
63 Issued in TN
Legal business name
BORDEAUX LONG TERM CARE
Practice address
1414 County Hospital Rd
Nashville, TN 37218-3023
Phone
(615) 862-7005
Fax
(615) 862-6960
NPI assigned
Sep 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Mr. Jason Boyd, FACHE
Title
Interim Ceo
Phone
(615) 341-4491

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0000000063 TN
Skilled Nursing Facility 314000000X 0000000063 TN
Skilled Nursing Facility 314000000X 63 TN Primary
Durable Medical Equipment & Medical Supplies 332B00000X 0175630001 TN
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 0175630001 TN
Long Term Care Pharmacy 3336L0003X 4646322 TN

Addresses

Primary practice location

1414 County Hospital Rd
Nashville, TN 37218-3023

Mailing address

1414 County Hospital Rd
Nashville, TN 37218-3023
Phone (615) 862-7005

Other identifiers 4

IdentifierTypeStateIssuer
1454877MedicaidTN
4414330OtherTNPHARMACY
7440149MedicaidTN
0445033MedicaidTN

Other names 1

  • Bordeaux Long-Term Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Metro Davidson Co Healt10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

63 Hermitage Ave
Nashville, TN 37210
Phone (615) 862-5367

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1083609168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 COUNTY HOSPITAL RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372183023",
            "telephone_number": "615-862-7005",
            "fax_number": "615-862-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 COUNTY HOSPITAL RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372183023",
            "telephone_number": "615-862-7005",
            "fax_number": "615-862-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORDEAUX LONG TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "615-341-4491",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000063",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000063",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "63",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0175630001",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TN",
            "license": "0175630001",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "4646322",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454877",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "4414330",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440149",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445033",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bordeaux Long-Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.