Active NPI
Community Care of Rutherford County, Inc.
- Skilled Nursing Facility
- Murfreesboro, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0000000219
- Legal business name
- COMMUNITY CARE OF RUTHERFORD COUNTY, INC.
- Practice address
- 901East County Farm Rd
Murfreesboro, TN 37127-6328 - Phone
- (615) 893-2624
- Fax
- (615) 898-7989
- NPI assigned
- Jul 28, 2005
- 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
- Mark King
- Title
- Administrator
- Phone
- (615) 893-2624
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0000000219 | TN | Primary |
| Nursing Facility Supplies (DME) | 332BN1400X | TN | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | TN |
Addresses
Primary practice location
901East County Farm Rd
Murfreesboro, TN 37127-6328
Mailing address
901 East County Farm Rd
Murfreesboro, TN 37127-6328
Phone (615) 893-2624
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7440175 | Medicaid | TN | |
| 0445406 | Medicaid | TN | |
| 4100484 | Other | TN | BLUECROSS ALLIED PROVIDER |
| 3110468 | Other | TN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120208000383 | TN | Part A Provider - Skilled Nursing Facility | 0042477739 | Practice locations: Murfreesboro, TN |
Skilled nursing facility certification: CCN 445406
- Legal name
- COMMUNITY CARE OF RUTHERFORD COUNTY, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1997
- Last certification
- May 11, 2022
- Beds
- 131
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Jul 7, 1987 in TN
- Enrollment address
- 901 County Farm Rd
Murfreesboro, TN 37127-6328 - Nursing home name
- COMMUNITY CARE OF RUTHERFORD
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Community Care of Rutherford
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 1, 1997
- Medicare certification status
- Active
- Certified beds
- 131
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0978867 | Community Care of Rutherford County | Certificate of waiver | Oct 4, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| Community Care of Rutherford County, Inc. | Operational/Managerial Control | Jul 7, 1987 | |
| Carol Cook | Corporate Director | Jan 1, 2004 | |
| Charles King | W-2 Managing Employee | Sep 26, 2000 | |
| Kaye Jernigan | Corporate Director | Jan 1, 2004 | |
| Frankie Johnson | Corporate Director | May 1, 2005 | |
| Bernard Lyles | Corporate Director | Dec 7, 1954 | |
| Paul Johnson | Corporate Director | May 2, 2007 | |
| Mike Nunley | Corporate Director | Jul 1, 1991 | |
| Ernest Burgess | Corporate Director | Sep 1, 2006 | |
| Other | Sep 1, 2006 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Family Medicine) Physician
- Hendersonville, TN
- NPI 1184612921
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Hendersonville, TN
- NPI 1184612921
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1227657600000",
"number": "1508866898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 EAST COUNTY FARM RD",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371276328",
"telephone_number": "615-893-2624",
"fax_number": "615-898-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901EAST COUNTY FARM RD",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371276328",
"telephone_number": "615-893-2624",
"fax_number": "615-898-7989"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY CARE OF RUTHERFORD COUNTY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-28",
"last_updated": "2008-11-26",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "615-893-2624"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TN",
"license": "0000000219",
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": "TN",
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "TN",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7440175",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0445406",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS ALLIED PROVIDER",
"identifier": "4100484",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3110468",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Murfreesboro, TN
- Kerry Jane Collins, FNP
- Kristen Ann Collins, SLP
- Columbia Radiation Oncology
- Come to Life Chiropractic, LLC
- Communication Connection, Inc
- Community Wellness and Intervention
- Compassion Eye Care PLLC
- Comprehensive Home Healthcare Services LLC
- Comprehensive Neurology Center, PLLC
- Comprehensive Neurology Center, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.