Organization Active NPI

Benchmark Healthcare of Puryear, Inc.

  • Skilled Nursing Facility
  • Puryear, TN
National Provider Identifier
1104989813
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000130 Issued in TN
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

Updated by the provider on Nov 8, 2013

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7440575MedicaidTN

Other names 1

  • Arbor Place of Puryear, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.