Active NPI
Siskin Hospital for Physical Rehabilitation
- Skilled Nursing Facility
- Chattanooga, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0000000113
- Legal business name
- SISKIN HOSPITAL FOR PHYSICAL REHABILITATION
- Doing business as
- Siskin Subacute West
St Barnabas at Siskin Hospital, Siskin West - Practice address
- 1 Siskin PLZ
Chattanooga, TN 37403-1306 - Phone
- (423) 847-4100
- Fax
- (423) 634-4587
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carol Arnhart
- Title
- Cfo
- Phone
- (423) 634-1587
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0000000113 | TN | Primary |
Addresses
Primary practice location
1 Siskin PLZ
Chattanooga, TN 37403-1306
Mailing address
1 Siskin PLZ
Chattanooga, TN 37403-1306
Phone (423) 847-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0445008 | Medicaid | TN | |
| 7440184 | Medicaid | TN |
Other names 2
- Siskin Subacute West
- St Barnabas at Siskin Hospital, Siskin West
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151005003309 | TN | Part A Provider - Skilled Nursing Facility | 5193708527 | Practice locations: Chattanooga, TN |
Skilled nursing facility certification: CCN 445008
- Legal name
- SISKIN HOSPITAL FOR PHYSICAL REHABILITATION
- Doing business as
- SISKIN SUBACUTE WEST, ST. BARNABAS AT SISKIN HOSPITAL, SISKIN WEST
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Oct 29, 2023
- Beds
- 108
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Sep 21, 1984 in TN
- Enrollment address
- 1 Siskin PLZ
Chattanooga, TN 37403-1306 - Nursing home name
- SISKIN SUBACUTE WEST
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Rehabilitation Hospital
- Chattanooga, TN
- NPI 1356388227
5193708527
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Siskin Subacute West
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 108
- Penalties (3 years)
- 1
National Provider Directory
National Provider Directory- Tax ID family
- Siskin Hospital for Physical Rehabilitation
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychologist
- Chattanooga, TN
- NPI 1043348113
Locations
950 Siskin Dr
Chattanooga, TN 37403
Phone (423) 847-1400
Ownership & related parties
All disclosed owners & managing parties 20
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Trudy a Harper | Corporate Officer | Oct 1, 2017 | 16.67% |
| Corporate Director | Jul 1, 2015 | 5.57% | |
| Michael Fillauer | Corporate Director | Jul 1, 2017 | 5.55% |
| Michael G Mathis | Corporate Officer | Jul 1, 2019 | 16.67% |
| Corporate Director | Jul 1, 2015 | 5.57% | |
| Ruchir Shah | Corporate Director | Jul 1, 2022 | 5.55% |
| Charles L Arant | Corporate Director | Jul 1, 2016 | 5.55% |
| Richard P McKenney | Corporate Director | Jul 1, 2015 | 5.55% |
| Jones Krogh | Corporate Officer | Jul 1, 2017 | 16.67% |
| Corporate Director | Jul 1, 2016 | 5.57% | |
| Rose Decosimo | Corporate Director | Nov 1, 2016 | 5.55% |
| Siskin Hospital for Physical Rehabilitation | 5% Or Greater Direct Ownership Interest | Jul 1, 2014 | 100% |
| Elizabeth McCright | Corporate Officer | Jul 1, 2021 | 16.67% |
| Corporate Director | Jul 1, 2017 | 5.55% | |
| William Wilder | Corporate Director | Jul 1, 2019 | 5.55% |
| Carol Arnhart | Corporate Officer | Jul 1, 2010 | 16.65% |
| W-2 Managing Employee | Jul 1, 2014 | 100% | |
| Marcus K Shaw | Corporate Director | Jul 1, 2018 | 5.55% |
| Jennifer L Weaver | Corporate Director | Jul 1, 2016 | 5.55% |
| Monique P Berke | Corporate Director | Jul 1, 2014 | 5.55% |
| David I Binder | Corporate Director | Jul 1, 2020 | 5.55% |
| Matthew a Gibson | Corporate Officer | Jan 29, 2020 | 16.65% |
| Corporate Director | Jan 29, 2020 | 5.57% | |
| W-2 Managing Employee | Jan 29, 2020 | 100% | |
| Valerie C Rutledge | Corporate Director | Jul 1, 2014 | 5.55% |
| Maria Laurel Graefe | Corporate Director | Jul 1, 2022 | 5.55% |
| William E Godbold | Corporate Director | Jul 1, 2022 | 5.55% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Rehabilitation Hospital
- Chattanooga, TN
- NPI 1356388227
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
- Chattanooga, TN
- NPI 1699909481
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
- Chattanooga, TN
- NPI 1699909481
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618876800000",
"number": "1326135898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SISKIN PLZ",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374031306",
"telephone_number": "423-847-4100",
"fax_number": "423-634-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SISKIN PLZ",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374031306",
"telephone_number": "423-847-4100",
"fax_number": "423-634-4587"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SISKIN HOSPITAL FOR PHYSICAL REHABILITATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-06",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A",
"authorized_official_last_name": "ARNHART",
"authorized_official_first_name": "CAROL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "423-634-1587"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TN",
"license": "0000000113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0445008",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7440184",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Siskin Subacute West",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St Barnabas at Siskin Hospital, Siskin West",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St Barnabas at Siskin Hospital, Siskin West",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.