NPIMap

Organization Active NPI

Redemption Recovery Center, LLC

Doing business as AppleGate Recovery - Jackson

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jackson, TN
National Provider Identifier
1235715830
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
REDEMPTION RECOVERY CENTER, LLC
Doing business as
AppleGate Recovery - Jackson
Practice address
23 Weatherford SQ
Jackson, TN 38305-2202
Phone
(731) 217-3777
NPI assigned
Mar 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

23 Weatherford SQ
Jackson, TN 38305-2202

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other practice location 1

303 E Poplar Ave
Selmer, TN 38375-1723
Phone (731) 217-3777

Other practice location 2

1010 Wayne Rd Ste 203
Savannah, TN 38372-1536
Phone (731) 217-3777

Other practice location 3

302 East Tickle Street
Dyersburg, TN 38024
Phone (731) 217-3777

Other practice location 4

115 Highway 641 S
Camden, TN 38320-1639
Phone (731) 217-3777

Other names 1

  • AppleGate Recovery - Jackson Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220201001049 TN Part B Supplier - Clinic/Group Practice 5698167427 Receives reassigned benefits from 3 practitioners
4 other NPIs on this enrollment
Practice locations: Selmer, TN; Savannah, TN; Dyersburg, TN; Camden, TN; Jackson, TN

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2216843Redemption Recovery Center LLC23 Weatherford Square, Jackson, TN 38305Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Applegate Recovery - Camden5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

302 E Tickle St
Dyersburg, TN 38024
Phone (731) 217-3777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1235715830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WEATHERFORD SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052202",
            "telephone_number": "731-217-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Selmer",
            "state": "TN",
            "postal_code": "383751723",
            "country_code": "US",
            "telephone_number": "731-217-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Wayne Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "TN",
            "postal_code": "383721536",
            "country_code": "US",
            "telephone_number": "731-217-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 East Tickle Street",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "38024",
            "country_code": "US",
            "telephone_number": "731-217-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Highway 641 S",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "TN",
            "postal_code": "383201639",
            "country_code": "US",
            "telephone_number": "731-217-3777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REDEMPTION RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AppleGate Recovery - Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.
  • 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.

Verify at the official NPI Registry.