Active NPI
Buffalo River Healthcare LLC
Doing business as Perry County Nursing Home
- Nursing Facility/Intermediate Care Facility
- Linden, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 0000000201
- Legal business name
- BUFFALO RIVER HEALTHCARE LLC
- Doing business as
- Perry County Nursing Home
- Practice address
- 127 East Brooklyn Avenue
Linden, TN 37096-3515 - Phone
- (931) 589-2134
- Fax
- (931) 589-3847
- NPI assigned
- Feb 15, 2007
- Last updated
- Jun 27, 2008
- 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. Brent Hinson, RN
- Title
- Administrator
- Phone
- (931) 589-2134
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0000000201 | TN | Primary |
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 names 1
- Perry County Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101216000438 | TN | Part A Provider - Skilled Nursing Facility | 6901094051 | Practice locations: Linden, TN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1164565206. Details of each certification follow.
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
- Incorporated
- Nov 20, 2010 in TN
- Enrollment address
- 127 E Brooklyn Ave
Linden, TN 37096-3375 - Nursing home name
- PERRY COUNTY NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Perry County Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 1, 2011
- Medicare certification status
- Active
- Certified beds
- 114
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 |
|---|---|---|---|
| 44D0856021 | Perry County Nursing Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 1
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 |
|---|---|---|---|
| Brent Hinson | 5% Or Greater Direct Ownership Interest | Nov 10, 2010 | |
| Corporate Director | Nov 10, 2010 | ||
| W-2 Managing Employee | Nov 10, 2010 |
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Internal Medicine Physician
- Linden, TN
- NPI 1063512390
-
- Family Medicine Physician
- Lobelville, TN
- NPI 1255302907
-
- Family Medicine Physician
- Linden, TN
- NPI 1922095561
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": "1171497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214524800000",
"number": "1164565206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 EAST BROOKLYN AVENUE",
"city": "LINDEN",
"state": "TN",
"postal_code": "370963515",
"telephone_number": "931-589-2134",
"fax_number": "931-589-3847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 EAST BROOKLYN AVENUE",
"city": "LINDEN",
"state": "TN",
"postal_code": "370963515",
"telephone_number": "931-589-2134",
"fax_number": "931-589-3847"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUFFALO RIVER HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-15",
"last_updated": "2008-06-27",
"status": "A",
"authorized_official_last_name": "HINSON",
"authorized_official_first_name": "BRENT",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "931-589-2134",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "TN",
"license": "0000000201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Perry County Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Linden, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.