Buffalo River Healthcare LLC
Organization Active NPI Nursing Facility/Intermediate Care Facility · Linden, TN
NPI 1164565206 · NPPES record last updated Jun 27, 2008
Key facts
- NPI
- 1164565206
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 0000000201 (TN)
- Legal business name
- BUFFALO RIVER HEALTHCARE LLC
- Practice address
- 127 East Brooklyn Avenue
Linden, TN 37096-3515 - Phone
- (931) 589-2134
- Fax
- (931) 589-3847
- NPI assigned
- Feb 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Brent Hinson, RN
- Title
- Administrator
- Phone
- (931) 589-2134
Practitioners 3
-
Stephen L Averett, M.D.
-
Jeffrey Galt Smith, M.D.
Affiliated clinicians 3
-
Stephen L Averett, M.D.
-
Jeffrey Galt Smith, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Perry County Nursing Home
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 1, 2011
- Medicare certification status
- Active
- Certified beds
- 114 · 85.5 residents per day on average
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0856021 | Perry County Nursing Home | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Skilled nursing facility certification: CCN 445503
- Legal name
- BUFFALO RIVER HEALTHCARE LLC
- Doing business as
- PERRY COUNTY NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 2011
- Last certification
- Dec 12, 2024
- Beds
- 114
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 20, 2010 in TN
- Enrollment address
- 127 E Brooklyn Ave
Linden, TN 37096-3375 - Nursing home name
- PERRY COUNTY NURSING HOME
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Brent Hinson |
5% Or Greater Direct Ownership Interest | Nov 10, 2010 | |
| Corporate Director | Nov 10, 2010 | ||
| W-2 Managing Employee | Nov 10, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101216000438 | TN | Part a Provider - Skilled Nursing Facility | 6901094051 | Practice locations: Linden, TN |
National Provider Directory
Locations
127 E Brooklyn St
Linden, TN 37096
Phone (931) 589-2134
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0000000201 | TN | Yes |
Addresses
Primary practice location
127 East Brooklyn Avenue
Linden, TN 37096-3515
Mailing address
127 East Brooklyn Avenue
Linden, TN 37096-3515
Phone (931) 589-2134
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7440536 | Medicaid | TN |
Other names
- Perry County Nursing Home
Other providers in Linden, TN
- Dana Bradford
- Brittan E Breeding
- Heather Breeding
- Alle Brown
- Shirley Bryant
- Buffalo River Medical
- Buffalo River Rehabilitation
- Buffalo River Transport
- William Brent Bush
- County of Perry
All providers in Linden, TN · Nursing Facility/Intermediate Care Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.