Active NPI
Benchmark Healthcare of Puryear, Inc.
- Skilled Nursing Facility
- Puryear, TN
National Provider Identifier
1104989813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0000000130
- Legal business name
- BENCHMARK HEALTHCARE OF PURYEAR, INC.
- Practice address
- 220 College St
Puryear, TN 38251-6441 - Phone
- (636) 536-5365
- Fax
- (636) 536-4533
- NPI assigned
- Dec 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John M. Sells
- Title
- President
- Phone
- (636) 536-5365
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0000000130 | TN | Primary |
Addresses
Primary practice location
220 College St
Puryear, TN 38251-6441
Mailing address
17826 Edison Ave
Chesterfield, MO 63005-1262
Phone (636) 536-5365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7440575 | Medicaid | TN |
Other names 1
- Arbor Place of Puryear, Inc.
National Provider Directory
National Provider DirectoryLocations
17826 Edison Ave
Chesterfield, MO 63005
Phone (636) 449-8888
220 College St
Puryear, TN 38251
Phone (636) 536-5365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383868800000",
"number": "1104989813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17826 EDISON AVE",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630051262",
"telephone_number": "636-536-5365",
"fax_number": "636-536-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 COLLEGE ST",
"city": "PURYEAR",
"state": "TN",
"postal_code": "382516441",
"telephone_number": "636-536-5365",
"fax_number": "636-536-4533"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BENCHMARK HEALTHCARE OF PURYEAR, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-18",
"last_updated": "2013-11-08",
"status": "A",
"authorized_official_last_name": "SELLS",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "636-536-5365",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TN",
"license": "0000000130",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7440575",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Arbor Place of Puryear, Inc.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Puryear, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.