Huntsville NH Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

223 Issued in TN

Legal business name

HUNTSVILLE NH OPERATIONS, LLC

Doing business as

Huntsville Manor

Practice address

287 Baker St
Huntsville, TN 37756-3444

Phone

(423) 663-3600

NPI assigned

Nov 16, 2005

Last updated

Sep 14, 2012By 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

Carla D Buttram, BSM LNHA

Title

Administrator

Phone

(423) 663-3600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Huntsville Manor Doing business as

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347580800000",
    "number": "1649252560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 BAKER ST",
            "city": "HUNTSVILLE",
            "state": "TN",
            "postal_code": "377563444",
            "telephone_number": "423-663-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 BAKER ST",
            "city": "HUNTSVILLE",
            "state": "TN",
            "postal_code": "377563444",
            "telephone_number": "423-663-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE NH OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-09-14",
        "status": "A",
        "authorized_official_last_name": "BUTTRAM",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-663-3600",
        "authorized_official_credential": "BSM  LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445288",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744-0485",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntsville Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rammy Scott Gilbert I, P.T. BS
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• Joan Rose Haase
• Beverly Jane Hicks
• Huntsville TN Opco LLC (Huntsville Health and Rehailitation)
• Ashton Jeffers
• Jerry L. Kline, FNP
• Lora J Litton, C.PH.T
• Pamela Lloyd

• Skilled Nursing Facility in Huntsville, TN
• Providers in Huntsville, 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 Sep 14, 2012; 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.