Organization Active NPI

Cumberland Rehabilitation Services LLC

  • Pediatric Rehabilitation Medicine Physician
  • Cookeville, TN
National Provider Identifier
1306358916
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
Legal business name
CUMBERLAND REHABILITATION SERVICES LLC
Practice address
1227 N Washington Ave Ste 106
Cookeville, TN 38501-1837
Phone
(931) 400-0725
Fax
(931) 400-0726
NPI assigned
Nov 5, 2017
Last updated
Mar 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Authorized official

Name
Jon AllenNPI 1083697221
Title
Managing Member
Phone
(931) 400-0725

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X NU Primary

Addresses

Primary practice location

1227 N Washington Ave Ste 106
Cookeville, TN 38501-1837

Mailing address

1227 N Washington Ave Ste 106
Cookeville, TN 38501-1837
Phone (931) 400-0725

Other practice location 1

370 S Lowe Ave Ste A330
Cookeville, TN 38501-4730
Phone (606) 224-6915

Other identifiers 1

IdentifierTypeStateIssuer
Q032252MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210211001146 TN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496167728 Receives reassigned benefits from 13 practitioners
Practice locations: Cookeville, TN

National Provider Directory

National Provider Directory

Locations

1227 N Washington Ave
Ste 106
Cookeville, TN 38501
Phone (931) 400-0724

370 S Lowe Ave
Ste A330
Cookeville, TN 38501
Phone (606) 224-6915

580 S Jefferson Ave
Ste 21
Cookeville, TN 38501
Phone (931) 219-2569

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1306358916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 N WASHINGTON AVE STE 106",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011837",
            "telephone_number": "931-400-0725",
            "fax_number": "931-400-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 N WASHINGTON AVE STE 106",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011837",
            "telephone_number": "931-400-0725",
            "fax_number": "931-400-0726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 S Lowe Ave Ste A330",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014730",
            "country_code": "US",
            "telephone_number": "606-224-6915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUMBERLAND REHABILITATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-05",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "931-400-0725"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032252",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.