Christian Care Center of Milan, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

CHRISTIAN CARE CENTER OF MILAN, LLC

Doing business as

Christian Care Center of Medina

Practice address

401 Promise Way LN
Medina, TN 38355-6967

Phone

(731) 462-0020

Fax

(731) 435-3638

NPI assigned

Jan 25, 2022

Last updated

Oct 5, 2022By 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

Lisa M Cawood Gray

Title

Delegated Official, Access Manager

Phone

(423) 557-6116

Specialties & licenses 1

Addresses

Other names 1

• CHRISTIAN CARE CENTER OF MEDINA Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619629250. Details of each certification follow.

• CCN 445539 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445539

Legal name

CHRISTIAN CARE CENTER OF MILAN, LLC

Doing business as

CHRISTIAN CARE CENTER OF MEDINA

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 29, 2022

Last certification

Mar 12, 2025

Beds

66

Ownership / control type

Nonprofit Corporation

Organization structure

LLCProprietary

Enrollment address

401 Promise Way LN
Medina, TN 38355-6967

Listed as

Christian Care Center of MedinaCCN 445539 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jun 29, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6661.0 residents per day on average

Penalties (3 years)

3Fines totaling $15,592

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 18

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 4

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

• Jere D Hammond, MD

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1891763819

  Adp of the SNF

  CMS ownership
• Jackson Clinic PA

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1285629386

  Adp of the SNF

  CMS ownership
• Jackson Clinic PA

  dba Jackson Clinc PA DME

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038

  Adp of the SNF

  CMS ownership
• Broad River Rehabilitation

  dba Broad River Rehab

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589

  Limited Partnership Interest

  CMS ownership

Facilities with the same owner 5

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

• Abundant Christian Living Community LLC

  • Skilled Nursing Facility
  • Johnson City, TN
  • NPI 1902491178

  Care Centers Management Consulting, Inc.

  CMS ownership
• Christian Care Center of Bolivar LLC

  • Skilled Nursing Facility
  • Bolivar, TN
  • NPI 1972181998

  Care Centers Management Consulting, Inc.

  CMS ownership
• Christian Care Center of Unicoi County LLC

  • Skilled Nursing Facility
  • Erwin, TN
  • NPI 1477037497

  Care Centers Management Consulting, Inc.

  CMS ownership
• Ivy Hall, Inc

  dba Ivy Hall Nursing Home

  • Skilled Nursing Facility
  • Elizabethton, TN
  • NPI 1851362511

  Care Centers Management Consulting, Inc.

  CMS ownership
• KDM Inc

  dba Durham-Hensley Health and Rehabilitation

  • Skilled Nursing Facility
  • Chuckey, TN
  • NPI 1124080221

  Care Centers Management Consulting, Inc.

  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.

• Jere D Hammond, MD

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1891763819
  NPD (past)

Affiliated clinicians 1

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

• Jere D Hammond, MD

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1891763819

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1619629250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 NORTHPARK DR STE 2D",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043127",
            "telephone_number": "423-975-5455",
            "fax_number": "423-390-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PROMISE WAY LN",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383556967",
            "telephone_number": "731-462-0020",
            "fax_number": "731-435-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CARE CENTER OF MILAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "CAWOOD GRAY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL, ACCESS MANAGER",
        "authorized_official_telephone_number": "423-557-6116"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTIAN CARE CENTER OF MEDINA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Medina, TN
• Providers in Medina, TN by specialty
• Nursing Facility/Intermediate Care Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.