NPIMap

Organization Active NPI

Clover Bottom Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • Nashville, TN
National Provider Identifier
1356785307
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
L000000011844 Issued in TN
Legal business name
CLOVER BOTTOM DEVELOPMENTAL CENTER
Practice address
275 Stewarts Ferry Pike
Nashville, TN 37214-3325
Phone
(615) 231-5000
Fax
(615) 231-5074
NPI assigned
Apr 22, 2013
Organization subpart
Yes
Parent organization
CLOVER BOTTOM DEVELOPMENTAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Dr. Stacey Lynn Dixon, PH.D.
Title
Chief Officer
Phone
(615) 231-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X L000000011844 TN Primary

Addresses

Primary practice location

275 Stewarts Ferry Pike
Nashville, TN 37214-3325

Mailing address

275 Stewarts Ferry Pike
Nashville, TN 37214-3325
Phone (615) 231-5000

Other identifiers 1

IdentifierTypeStateIssuer
7447010MedicaidTN

Other names 1

  • Day One Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Trousdale County Health202 organizations share this tax ID, including this one
Part of
Trousdale County Health

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1356785307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 STEWARTS FERRY PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143325",
            "telephone_number": "615-231-5000",
            "fax_number": "615-231-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 STEWARTS FERRY PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143325",
            "telephone_number": "615-231-5000",
            "fax_number": "615-231-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER BOTTOM DEVELOPMENTAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLOVER BOTTOM DEVELOPMENTAL CENTER",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "615-231-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TN",
            "license": "L000000011844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447010",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Day One",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.