NPIMap

Organization Active NPI

Selmer SNF Healthcare LLC

Doing business as Selmer Post Acute

  • Skilled Nursing Facility
  • Selmer, TN
National Provider Identifier
1629805049
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SELMER SNF HEALTHCARE LLC
Doing business as
Selmer Post Acute
Practice address
835 E Poplar Ave
Selmer, TN 38375-1851
Phone
(731) 645-3201
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

835 E Poplar Ave
Selmer, TN 38375-1851

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • SELMER POST ACUTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251016000764 TN Part A Provider - Skilled Nursing Facility 4486141108 Practice locations: Selmer, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629805049. Details of each certification follow.

Skilled nursing facility certification: CCN 445452

Legal name
SELMER SNF HEALTHCARE LLC
Doing business as
SELMER POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 2002
Last certification
Mar 17, 2022
Beds
126
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Selmer SNH Healthcare LLC
Most recent change of ownership
Jan 1, 2025
Organization structure
LLCProprietary
Enrollment address
835 E Poplar Ave
Selmer, TN 38375-1851
Nursing home name
SELMER POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Selmer Post AcuteCCN 445452 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12692.9 residents per day on average
Chain
Pacs Group274 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0659424Selmer SNF Healthcare LLC835 E Poplar Street, Selmer, TN 38375Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Branch Banking & Trust Company Organization, Charlotte, NC Corporation, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Jan 1, 2025 100%
Jason H Murray Individual 5% Or Greater Indirect Ownership InterestDirector - Pacs Group, Inc Jan 1, 2025 35.2%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2025
Robert Patterson Individual Managing Control - Governing BodyMaintenance Director Jan 1, 2025
James D King Individual Managing Control - Governing BodyMedical Director Jan 1, 2025
Adp of the SNF Jan 1, 2025
Sally a Lilly Individual Managing Control - Governing BodyDirector of Rehabilitation Jan 1, 2025
Sarah Henson Individual Managing Control - Governing BodyDietary Director Jan 1, 2025
Truist Bank Organization, Charlotte, NC Corporation, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Jan 1, 2025 100%
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2025
Providence Group NH, LLC Organization, Farmington, UT LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2025 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
Providence Administrative Consulting Services Inc Organization, Farmington, UT Corporation, Consulting firm, For-profit Adp of the SNF Jan 22, 2025
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2025
Betsy Borden Individual Managing Control - Governing BodyDirector of Nursing Jan 1, 2025
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025 100%
Kimberly Thompson Individual Operational/Managerial Control Jan 1, 2025
Managing Control - Governing BodySNF Administrator Jan 1, 2025
Adp of the SNF Mar 11, 2025
Janis Coleman Individual Managing Control - Governing BodyDietary Director Jan 1, 2025
Mark D Hancock Individual 5% Or Greater Indirect Ownership InterestDirector - Pacs Group, Inc Jan 1, 2025 35.2%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 186

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

View all 186

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1629805049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E POPLAR AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383751851",
            "telephone_number": "731-645-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELMER SNF HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELMER POST ACUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Selmer, TN

Sources for this page

Verify at the official NPI Registry.