Active NPI
Burns Nursing Home, Inc.
- Skilled Nursing Facility
- Russellville, AL
National Provider Identifier
1164496691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- BURNS NURSING HOME, INC.
- Practice address
- 701 Monroe St NW
Russellville, AL 35653-1358 - Phone
- (256) 332-4110
- Fax
- (256) 332-4163
- NPI assigned
- Feb 13, 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
- Mark S Dearman, N.H.A.
- Title
- Administrator
- Phone
- (256) 332-4110
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
701 Monroe St NW
Russellville, AL 35653-1358
Mailing address
701 Monroe St NW
Russellville, AL 35653-1358
Phone (256) 332-4110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-50090S | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120411000673 | AL | Part A Provider - Skilled Nursing Facility | 0244359412 | Practice locations: Russellville, AL |
Skilled nursing facility certification: CCN 015009
- Legal name
- BURNS NURSING HOME, INC.
- Doing business as
- BURNS NURSING HOME INC
- Certification status
- Active
- Provider type (POS)
- Nursing home โ SNF/NF dual certification
- Participating since
- Sep 1, 1969
- Last certification
- Mar 2, 2023
- Beds
- 57
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Sep 1, 1969 in AL
- Enrollment address
- 701 Monroe St NW
Russellville, AL 35653-1358 - Nursing home name
- BURNS NURSING HOME, INC.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Burns Nursing Home, Inc.
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 1, 1969
- Medicare certification status
- Active
- Certified beds
- 57
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Mark S Dearman | Corporate Officer | Dec 26, 2019 | |
| Other | Jun 13, 2011 | 4.5% | |
| Cameron S Dearman | 5% Or Greater Direct Ownership Interest | Jan 25, 2012 | 4.5% |
| Corporate Officer | Dec 26, 2019 | ||
| Martha B Dearman | 5% Or Greater Direct Ownership Interest | Sep 1, 1969 | 81% |
| Corporate Officer | Sep 1, 1969 | 100% | |
| Corporate Director | Sep 7, 1969 | 100% | |
| W-2 Managing Employee | Sep 1, 1969 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Russellville, AL
- NPI 1710972385
-
- Family Medicine Physician
- Hackleburg, AL
- NPI 1386656619
Affiliated clinicians 2
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": "1139788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724889600000",
"number": "1164496691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 MONROE ST NW",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "356531358",
"telephone_number": "256-332-4110",
"fax_number": "256-332-4163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 MONROE ST NW",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "356531358",
"telephone_number": "256-332-4110",
"fax_number": "256-332-4163"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BURNS NURSING HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-13",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A",
"authorized_official_last_name": "DEARMAN",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "256-332-4110",
"authorized_official_credential": "N.H.A."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47-50090S",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Russellville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.