NPIMap

Organization Active NPI

Claiborne Care Center

  • Skilled Nursing Facility
  • New Tazewell, TN
National Provider Identifier
1255043121
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CLAIBORNE CARE CENTER
Practice address
902 Buchanan Rd
New Tazewell, TN 37825-7410
Phone
(423) 626-8215
NPI assigned
Dec 22, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Brenda Campbell
Title
Ar Billing Manager
Phone
(859) 255-0075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

902 Buchanan Rd
New Tazewell, TN 37825-7410

Mailing address

1050 Chinoe Rd Ste 350
Lexington, KY 40502-6571
Phone (859) 255-0075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230530001149 TN Part A Provider - Skilled Nursing Facility 5496112971 Practice locations: New Tazewell, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255043121. Details of each certification follow.

Skilled nursing facility certification: CCN 445156

Legal name
CLAIBORNE CARE CENTER
Doing business as
EXCEPTIONAL LIVING CENTERS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 10, 1983
Last certification
Jun 29, 2022
Beds
134
Ownership / control type
Corporation
Multi-facility organization
EXCEPTIIONAL LIVING CENTERS
Most recent change of ownership
Feb 1, 2023
Organization structure
LLCProprietary
Incorporated
Dec 9, 2022 in KY
Enrollment address
902 Buchanan Rd
New Tazewell, TN 37825-7410
Nursing home name
BUCHANAN PLACE
Affiliated entity
EXCEPTIONAL LIVING CENTERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Buchanan PlaceCCN 445156 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 10, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13481.5 residents per day on average
Chain
Exceptional Living Centers10 facilities in the chain
Penalties (3 years)
1Fines totaling $8,021

Processed by Care Compare on Aug 1, 2026.

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
44D0877248Claiborne Care Center LLC902 Buchanan Rd, New Tazewell, TN 37825Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amy H Watts Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 50%
Walter T Watts Individual 5% Or Greater Indirect Ownership InterestManager Feb 1, 2023 50%
Corporate OfficerPresident and Ceo Feb 1, 2023 100%
Adp of the SNF Feb 1, 2023
Brenda Campbell Individual Operational/Managerial Control Feb 1, 2023
Adp of the SNF Feb 1, 2023
Jodie a Jones Individual Operational/Managerial Control Nov 25, 2024
Managing Control - Governing BodyAdministrator Nov 25, 2024
Adp of the SNF Nov 25, 2024
Charles H. Debusk Individual Operational/Managerial Control Feb 1, 2023
Managing Control - Governing BodyMedical Director Feb 1, 2023
Adp of the SNF Feb 1, 2023
Medical Rehabilitation Centers, LLC Organization, Lexington, KY LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2023 100%
Lexington Health Management LLC Organization, Lexington, KY LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Charles H Debusk, M.D.
    • Family Medicine Physician
    • New Tazewell, TN
    • NPI 1780665745

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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.

Affiliated clinicians 1

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": "1671667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1255043121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 CHINOE RD STE 350",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405026571",
            "telephone_number": "859-255-0075",
            "fax_number": "859-281-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BUCHANAN RD",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378257410",
            "telephone_number": "423-626-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIBORNE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "AR BILLING MANAGER",
        "authorized_official_telephone_number": "859-255-0075"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Tazewell, TN

Sources for this page

Verify at the official NPI Registry.