NPIMap

Organization Active NPI

Centerville Medical Investors, LLC

Doing business as Life Care Center of Centerville

  • Skilled Nursing Facility
  • Centerville, TN
National Provider Identifier
1326074402
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
131 Issued in TN
Legal business name
CENTERVILLE MEDICAL INVESTORS, LLC
Doing business as
Life Care Center of Centerville
Practice address
112 Old Dickson Road
Centerville, TN 37033
Phone
(931) 729-4236
Fax
(931) 729-5489
NPI assigned
Jun 23, 2006
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 131 TN Primary

Addresses

Primary practice location

112 Old Dickson Road
Centerville, TN 37033

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other names 1

  • Life Care Center of Centerville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000291 TN Part A Provider - Skilled Nursing Facility 7113985516 Practice locations: Centerville, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326074402. Details of each certification follow.

Skilled nursing facility certification: CCN 445252

Legal name
CENTERVILLE MEDICAL INVESTORS, LLC
Doing business as
LIFE CARE CENTER OF CENTERVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 14, 1990
Last certification
Sep 12, 2024
Beds
132
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America
Most recent change of ownership
Jan 18, 2005
Organization structure
LLCProprietary
Enrollment address
112 Old Dickson Road
Centerville, TN 37033-1402
Nursing home name
LIFE CARE CENTER OF CENTERVILLE
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of CentervilleCCN 445252 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 14, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13267.7 residents per day on average
Chain
Life Care Centers of America194 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
44D0306623Centerville Medical Investors, LLC112 Old Dickson Rd, Centerville, TN 37033Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

112 Dickson Rd
Centerville, TN 37033
Phone (931) 729-4236

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Sep 30, 2004 99.01%
Adp of the SNF May 19, 2011
Direct Ownership Interest Sep 30, 2004 99.01%
Indirect Ownership Interest Sep 30, 2004 0.99%
Terry Henry Individual Corporate DirectorAssistant Treasurer of MGMT. Co. Oct 13, 2004
Todd Fletcher Individual Operational/Managerial Control Dec 13, 2024
Organization, Cleveland, TN LLC, For-profit Adp of the SNF May 19, 2011
Developers Investment Company Inc Organization, Cleveland, TN Corporation, For-profit Operational/Managerial Control Jan 17, 2006
Direct Ownership Interest Sep 30, 2004 0.99%
Aubrey Preston Individual Operational/Managerial Control Dec 13, 2024
Joan E Thurmond Individual Corporate OfficerAssist. Secretary of MGMT. Co. Oct 13, 2004
Cindy S Cross Individual Corporate OfficerVP / Assist. Secretary of MGMT. Co. Oct 13, 2004
Beverly a Wall Individual Operational/Managerial Control Nov 12, 2012
Managing Control - Governing BodyAdministrator Nov 12, 2012
Adp of the SNF Mar 4, 2025
Brandi Neice Individual Operational/Managerial Control Nov 3, 2021
Managing Control - Governing BodyDirector of Nursing Nov 3, 2021
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Mar 4, 2025
Richard Swanker Individual Corporate OfficerChief Tax Officer of MGMT. Co. Apr 1, 2011
Corporate DirectorDirector of MGMT. Co. Jan 1, 2022
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Oct 13, 2004 100%
Adp of the SNF Mar 4, 2025
Zachary M Hutchens Individual Operational/Managerial Control Jan 1, 2017
Adp of the SNF Mar 4, 2025
Lisa M Lay Individual Corporate OfficerSecretary of MGMT. Co. Feb 9, 2018
Corporate DirectorDirector of MGMT. Co. Apr 24, 2017
James Ziegler Individual Operational/Managerial Control Dec 13, 2024
Jennifer Solomon Individual Operational/Managerial Control May 1, 2019
Managing Control - Governing BodyDivision Vice President May 1, 2019

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 193

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

View all 193

Practitioners & affiliated clinicians

Practitioners 2

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 2

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1326074402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 OLD DICKSON ROAD",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "37033",
            "telephone_number": "931-729-4236",
            "fax_number": "931-729-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Centerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerville, TN

Sources for this page

Verify at the official NPI Registry.