NPIMap

Organization Active NPI

Tennessee State Veterans Home Board

  • Skilled Nursing Facility
  • Cleveland, TN
National Provider Identifier
1649957721
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TENNESSEE STATE VETERANS HOME BOARD
Practice address
1940 Westland Dr SW
Cleveland, TN 37311
Phone
(423) 202-8132
NPI assigned
Jun 30, 2023
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Danielle Brown
Title
Finance Director
Phone
(615) 225-1808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1940 Westland Dr SW
Cleveland, TN 37311

Mailing address

PO Box 11328
Murfreesboro, TN 37129-0027
Phone (615) 225-1808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240116000973 TN Part A Provider - Skilled Nursing Facility 0941296198 Practice locations: Cleveland, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649957721. Details of each certification follow.

Skilled nursing facility certification: CCN 445543

Legal name
TENNESSEE STATE VETERANS HOME BOARD
Doing business as
TENNESSEE STATE VETERANS HOME-CLEVELAND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 16, 2024
Last certification
Feb 16, 2024
Beds
108
Ownership / control type
State
Multi-facility organization
Tennessee State Veterans Home Board
Organization structure
GovernmentNon-profit
Incorporated
Jan 1, 1996 in TN
Enrollment address
1940 Westland Dr SW
Cleveland, TN 37311-8102
Nursing home name
TENNESSEE STATE VETERANS HOME- CLEVELAND
Affiliated entity
TENNESSEE STATE VETERANS' HOME

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Tennessee State Veterans Home- ClevelandCCN 445543 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Feb 16, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
108101.7 residents per day on average
Chain
Tennessee State Veterans' Home5 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $13,520

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
44D2283857Tennessee State Veterans Homes-Cleveland1940 Westland Dr SW, Cleveland, TN 37311Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tennessee State Veterans Home Board-Arlington6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Courtney Bledsoe Individual Operational/Managerial Control Jul 11, 2022
Adp of the SNF Mar 20, 2026
Adam Fleming Individual Operational/Managerial Control Apr 20, 2024
Edward Harries Individual Operational/Managerial Control Jan 11, 2010
Robert Eric Jackson Individual Operational/Managerial Control Jun 21, 2024
Adp of the SNF Jun 21, 2024

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Senator Ben Atchley Tennessee State Veterans HomeKnoxville, TN, CCN 445484 Skilled nursing facility Operational/Managerial Control (100%) Oct 1, 2006
Tennessee State Veterans HomeMurphreesboro, TN, CCN 445270 Skilled nursing facility Operational/Managerial Control (100%) Aug 1, 2006

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 3

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": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1649957721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11328",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371290027",
            "telephone_number": "615-225-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 WESTLAND DR SW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37311",
            "telephone_number": "423-202-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE STATE VETERANS HOME BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "615-225-1808"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.