Organization Active NPI

HQM of Montgomery County, LLC

  • Skilled Nursing Facility
  • Clarksville, TN
National Provider Identifier
1255360699
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0191 Issued in TN
Legal business name
HQM OF MONTGOMERY COUNTY, LLC
Doing business as
Montgomery Care & Rehabilitation Center
Practice address
198 Old Farmers Road
Clarksville, TN 37043
Phone
(931) 358-2900
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Paul Walczak
Title
Ceo
Phone
(561) 627-0664

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0191 TN
Skilled Nursing Facility 314000000X 0191 TN Primary

Addresses

Primary practice location

198 Old Farmers Road
Clarksville, TN 37043

Mailing address

198 Old Farmers Rd
Clarksville, TN 37043-4032
Phone (931) 358-2900

Other identifiers 2

IdentifierTypeStateIssuer
0445448MedicaidTN
7440143MedicaidTN

Other names 1

  • Montgomery Care & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1255360699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 OLD FARMERS RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434032",
            "telephone_number": "931-358-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 OLD FARMERS ROAD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-358-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HQM OF MONTGOMERY COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WALCZAK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-627-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0191",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445448",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440143",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Care & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.