SLF No. 1 LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000312 Issued in TN

Legal business name

SLF NO. 1 LLC

Doing business as

Wyndridge Health & Rehab

Practice address

456 Wayne Ave
Crossville, TN 38555-4206

Phone

(931) 484-6129

Fax

(931) 484-2685

NPI assigned

Aug 3, 2006

Last updated

Aug 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Brewer

Title

Administrator

Phone

(931) 484-6129

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wyndridge Health & Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427066786. Details of each certification follow.

• CCN 445304 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445304

Legal name

SLF NO. 1 LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 9, 1992

Last certification

Nov 30, 2022

Beds

157

Ownership / control type

Nonprofit Corporation

Organization structure

LLCNon-profit

Enrollment address

456 Wayne Ave
Crossville, TN 38555-4206

Nursing home name

WYNDRIDGE HEALTH AND REHAB CTR

Listed as

Wyndridge Health and Rehab CtrCCN 445304 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Nov 9, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

15788.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Dwight H Willett, M.D.

  • Family Medicine Physician
  • Kingston, TN
  • NPI 1598746554

  Adp of the SNF

  CMS ownership

Practitioners 1

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.

• Dwight H Willett, M.D.

  • Family Medicine Physician
  • Kingston, TN
  • NPI 1598746554
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Thomas Arthur Allingham, D.O.

  • Critical Care Medicine (Anesthesiology) Physician
  • Crossville, TN
  • NPI 1184602369

  Nursing home

  Care Compare affiliation
• Dwight H Willett, M.D.

  • Family Medicine Physician
  • Kingston, TN
  • NPI 1598746554

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1427066786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554206",
            "telephone_number": "931-484-6129",
            "fax_number": "931-484-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554206",
            "telephone_number": "931-484-6129",
            "fax_number": "931-484-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLF NO. 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-484-6129",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SKILLED",
            "identifier": "445304",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyndridge Health & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Marie Simms, D.O.
• Jon Alan Simpson, MD
• Kara Sixkiller
• Skin Aesthetics LLC (127 SKIN Medical Aesthetics)
• Sleep Centers of Tennessee,Inc
• Allyna Noel Smith, OTD, OTR/L
• Amanda Lashae Smith, LMT
• Darryl Glenn Smith, DDS
• Michael Donovan Smith, RBT
• Robbie R. Smith, NP

• Skilled Nursing Facility in Crossville, TN
• Providers in Crossville, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.

Verify at the official NPI Registry.