Active NPI
LP Cookeville, LLC
Doing business as Signature HealthCARE of Putnam County
- Skilled Nursing Facility
- Cookeville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- LP COOKEVILLE, LLC
- Doing business as
- Signature HealthCARE of Putnam County
- Practice address
- 278 Dry Valley Rd
Cookeville, TN 38506-5461 - Phone
- (931) 537-6524
- Fax
- (931) 537-3013
- NPI assigned
- Mar 5, 2014
- Last updated
- Apr 4, 2023
- 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
- John Harrison
- Title
- Cfo
- Phone
- (502) 568-7800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | TN | Primary |
Addresses
Primary practice location
278 Dry Valley Rd
Cookeville, TN 38506-5461
Mailing address
278 Dry Valley Rd
Cookeville, TN 38506-5461
Phone (931) 537-6524
Other names 1
- Signature HealthCARE of Putnam County
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140502000282 | TN | Part A Provider - Skilled Nursing Facility | 1052544897 | Practice locations: Cookeville, TN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1144645870. Details of each certification follow.
Skilled nursing facility certification: CCN 445136
- Legal name
- LP COOKEVILLE LLC
- Doing business as
- SIGNATURE HEALTHCARE OF PUTNAM COUNTY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 29, 1980
- Last certification
- May 18, 2023
- Beds
- 175
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Signature Healthcare
- Most recent change of ownership
- May 1, 2014
- Organization structure
- LLC
- Incorporated
- Feb 4, 2014 in DE
- Enrollment address
- 278 Dry Valley Rd
Cookeville, TN 38506-5461 - Nursing home name
- SIGNATURE HEALTHCARE OF PUTNAM COUNTY
- Affiliated entity
- SIGNATURE HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Signature Healthcare of Putnam County
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 29, 1980
- Medicare certification status
- Active
- Certified beds
- 175
- Chain
- Signature Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0316130 | LP Cookeville, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
12201 Bluegrass Pkwy
Fl 2
Louisville, KY 40299
Ownership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Paula S Boone | W-2 Managing Employee | Jan 16, 2023 | |
| Ira Smedra | 5% Or Greater Indirect Ownership Interest | May 1, 2014 | 12% |
| Asbr Holdings LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2018 | 100% |
| Signature Healthcare LLC | Other | May 1, 2014 | |
| SHC LP Holdings LLC | 5% Or Greater Direct Ownership Interest | May 1, 2014 | 100% |
| Lpsnf LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2014 | 74% |
| John H Harrison | Corporate Officer | May 1, 2014 | |
| Wheaten LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2014 | 5% |
| Elmer Joseph Steier III | 5% Or Greater Indirect Ownership Interest | May 1, 2014 | 20% |
| Jjla LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2014 | 20% |
Facilities with the same owner 67
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Pickett Care & Rehabilitation Center
- Nursing Facility/Intermediate Care Facility
- Byrdstown, TN
- NPI 1407047798
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Clarksville
- Nursing Facility/Intermediate Care Facility
- Clarksville, TN
- NPI 1891985131
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature HealthCARE of Cleveland
- Nursing Facility/Intermediate Care Facility
- Cleveland, TN
- NPI 1508057456
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Elizabethton Rehab & Wellness Center
- Nursing Facility/Intermediate Care Facility
- Elizabethton, TN
- NPI 1255521555
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Erin
- Nursing Facility/Intermediate Care Facility
- Erin, TN
- NPI 1457541872
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Greeneville
- Nursing Facility/Intermediate Care Facility
- Greeneville, TN
- NPI 1699966986
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Fentress County
- Nursing Facility/Intermediate Care Facility
- Jamestown, TN
- NPI 1174713598
Jjla LLC, Wheaten LLC
-
dba Princeton Transitional Care & Assisted Living
- Skilled Nursing Facility
- Johnson City, TN
- NPI 1043798424
Jjla LLC, Lpsnf LLC, Wheaten LLC
-
dba Signature HealthCARE of Memphis
- Nursing Facility/Intermediate Care Facility
- Memphis, TN
- NPI 1831380120
Jjla LLC, Wheaten LLC
-
dba Signature HealthCARE of Primacy
- Skilled Nursing Facility
- Memphis, TN
- NPI 1760898415
Asbr Holdings LLC, Jjla LLC, Lpsnf LLC, SHC LP Holdings LLC, Wheaten LLC
-
dba Signature HealthCARE of Monteagle Rehab & Wellness Center
- Nursing Facility/Intermediate Care Facility
- Monteagle, TN
- NPI 1528259561
Jjla LLC, Wheaten LLC
-
dba Standing Stone Care & Rehabilitation Center
- Nursing Facility/Intermediate Care Facility
- Monterey, TN
- NPI 1922299213
Jjla LLC, Wheaten LLC
Practitioners & affiliated clinicians
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.
-
- Family Medicine Physician
- Cookeville, TN
- NPI 1831181205
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680566400000",
"number": "1144645870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "278 DRY VALLEY RD",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385065461",
"telephone_number": "931-537-6524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "278 DRY VALLEY RD",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385065461",
"telephone_number": "931-537-6524",
"fax_number": "931-537-3013"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LP COOKEVILLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-05",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A",
"authorized_official_last_name": "HARRISON",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "502-568-7800"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Signature HealthCARE of Putnam County",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Signature HealthCARE of Putnam County",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.