NPIMap

Organization Active NPI

Civic Center Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Birmingham, AL
National Provider Identifier
1255387379
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CIVIC CENTER HEALTH AND REHABILITATION, LLC
Practice address
1201 22ND St N
Birmingham, AL 35234-2726
Phone
(205) 251-5271
NPI assigned
May 26, 2006
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1201 22ND St N
Birmingham, AL 35234-2726

Mailing address

1201 22ND St N
Birmingham, AL 35234-2726
Phone (205) 251-5271

Other identifiers 2

IdentifierTypeStateIssuer
013203OtherALBCBS ID
4757590SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021028000015 AL Part A Provider - Skilled Nursing Facility 2163330689 Practice locations: Birmingham, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255387379. Details of each certification follow.

Skilled nursing facility certification: CCN 015109

Legal name
CIVIC CENTER HEALTH AND REHABILITATION, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 4, 1969
Last certification
Mar 22, 2024
Beds
95
Ownership / control type
Corporation
Multi-facility organization
NHS Management, LLC
Organization structure
LLCProprietary
Incorporated
Aug 20, 2002 in AL
Enrollment address
1201 22ND St N
Birmingham, AL 35234-2726
Nursing home name
CIVIC CENTER HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Civic Center Health and Rehabilitation, LLCCCN 015109 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 4, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9587.0 residents per day on average
Chain
NHS Management43 facilities in the chain

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
01D0674641Civic Center Health and Rehabilitation1201 22ND Street North, Birmingham, AL 35234Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Aug 20, 2002 5.32%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Aug 20, 2002 5.32%
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Aug 20, 2002 89.36%
Corporate OfficerPresident/Treasurer Aug 20, 2002 100%
NHS Operations LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Direct Ownership Interest Aug 20, 2002 100%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Other Jan 1, 2022 10.64%
Stella Webb Individual W-2 Managing EmployeeAdministrator Nov 26, 2018 100%
Operational/Managerial ControlAdministrator Nov 26, 2018 100%
Civic Center Health Realty LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Security Interest Oct 1, 2002
Berkadia Commercial Mortgage LLC Organization, Horsham, PA LLC, Financial institution, For-profit 5% Or Greater Mortgage Interest Jul 26, 2006 100%
5% Or Greater Security Interest Jul 26, 2006 100%
Letchernique Holmes Individual Corporate DirectorRegional Nurse Consultant Jan 3, 2022 33%
Operational/Managerial ControlRegional Nurse Consultant Jan 3, 2022 33%
Regions Bank Organization, Birmingham, AL Corporation, Financial institution, For-profit 5% Or Greater Security Interest Aug 27, 2012
Brandon S. Agee Individual Other Jan 1, 2022 10.64%
Derek Patterson Individual Corporate DirectorRegional Administrator Jan 3, 2022 33%
Operational/Managerial ControlRegional Administrator Jan 3, 2022 33%
NHS Management LLC Organization, Tuscaloosa, AL LLC, For-profit Other Jun 1, 2007

Facilities with the same owner 40

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

View all 40

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1255387379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 22ND ST N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352342726",
            "telephone_number": "205-251-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 22ND ST N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352342726",
            "telephone_number": "205-251-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVIC CENTER HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "013203",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757590S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.