NPIMap

Organization Active NPI

Middle Tennessee Homes

  • Intellectual Disabilities Intermediate Care Facility
  • Old Hickory, TN
National Provider Identifier
1255712832
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
MIDDLE TENNESSEE HOMES
Practice address
4937 Saundersville Road
Old Hickory, TN 37138
Phone
(615) 231-5373
Fax
(615) 231-5074
NPI assigned
Jun 9, 2015
Last updated
Jun 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Ms. Jama McCroskey Phillips, BS
Title
Middle Tennessee Homes Director
Phone
(615) 231-5373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

4937 Saundersville Road
Old Hickory, TN 37138

Mailing address

400 Deadrick Street
Citizens Plaza Suite 900
Nashville, TN 37243
Phone (615) 231-5373

Other identifiers 6

IdentifierTypeStateIssuer
7447184MedicaidTN
7447188MedicaidTN
7447186MedicaidTN
7447187MedicaidTN
7447010MedicaidTN
7447185MedicaidTN

Other names 1

  • Saundersville Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255712832. Details of each certification follow.

  • CCN 44G176 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 44G176

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MIDDLE TN HOMES SAUNDERSVILLE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 17, 2015
Last certification
Nov 6, 2024
Beds
4
Ownership / control type
State
Facility address
4937 Saundersville Road
Old Hickory, TN 37138

National Provider Directory

National Provider Directory
Tax ID family
Loudon County Health de202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1255712832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DEADRICK STREET",
            "address_2": "CITIZENS PLAZA SUITE 900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37243",
            "telephone_number": "615-231-5373",
            "fax_number": "615-231-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 SAUNDERSVILLE ROAD",
            "city": "OLD HICKORY",
            "state": "TN",
            "postal_code": "37138",
            "telephone_number": "615-231-5373",
            "fax_number": "615-231-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JAMA",
        "authorized_official_middle_name": "MCCROSKEY",
        "authorized_official_title_or_position": "MIDDLE TENNESSEE HOMES DIRECTOR",
        "authorized_official_telephone_number": "615-231-5373",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447184",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447188",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447186",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447187",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447010",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447185",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saundersville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Old Hickory, TN

Sources for this page

Verify at the official NPI Registry.