Comprehensive Rehabilitation of Lafayette Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

COMPREHENSIVE REHABILITATION OF LAFAYETTE INC

Practice address

505 Ellington Dr Ste a
Lafayette, TN 37083-1074

Phone

(615) 666-5095

Fax

(615) 802-6194

NPI assigned

Jul 1, 2005

Last updated

May 10, 2022By 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

Buffy S Roark, PTNPI 1932544921

Title

President

Phone

(615) 666-5095

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083611313. Details of each certification follow.

• CCN 446520 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 446520

Legal name

COMPREHENSIVE REHAB INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 25, 1984

Last certification

Jun 8, 2022

Ownership / control type

Proprietary

Most recent change of ownership

Nov 30, 2007

Facility address

505 Ellington Drive Suite a
Lafayette, TN 37083

Locations

Practitioners 2

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.

• Buffy Roark, PT

  • Physical Therapist
  • Lafayette, TN
  • NPI 1932544921
  NPD Authorized official
• Tonya D Creasy, PHYSICAL THERAPIST

  • Physical Therapist
  • Lafayette, TN
  • NPI 1760971121
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1083611313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370830629",
            "telephone_number": "615-666-5095",
            "fax_number": "615-666-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ELLINGTON DR STE A",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831074",
            "telephone_number": "615-666-5095",
            "fax_number": "615-802-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE REHABILITATION OF LAFAYETTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "BUFFY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-666-5095",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "37567",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446520",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie Keith Chitwood, DPH.
• Stanley Allen Chunn, MD
• Lisa Claiborne, RN MSN CS FNP
• Mary Anne Claiborne, FNP-BC
• Calamity Jane Coley
• John Steven Conger
• Bailey Cook
• Sagan Lasha Cook, LPN
• Lynn J Cothron, DMD
• County of Macon Office of County Executive (Macon County EMS)

• Rehabilitation Clinic/Center in Lafayette, TN
• Providers in Lafayette, TN by specialty
• Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.