Old Folks Mission Center,Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0445447 Issued in TN

Legal business name

OLD FOLKS MISSION CENTER,INC.

Doing business as

Mission Convalescent Home

Practice address

118 Glass St
Jackson, TN 38301-4625

Phone

(731) 424-2951

Fax

(731) 424-7915

NPI assigned

Jul 1, 2006

Last updated

Feb 8, 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

Mr. Duane Cherry, NHA

Title

Administrator

Phone

(731) 424-2951

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mission Convalescent Home 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 1689603755. Details of each certification follow.

• CCN 445447 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445447

Legal name

OLD FOLKS MISSION CENTER,INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 2002

Last certification

Sep 18, 2024

Beds

57

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 5, 1961 in TN

Enrollment address

118 Glass St
Jackson, TN 38301-4625

Nursing home name

MISSION CONVALESCENT HOME

Listed as

Mission Convalescent HomeCCN 445447 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Apr 1, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5741.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 2

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

• Samuel Olaniyi Bada, M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1770530586
  NPD (past)

Affiliated clinicians 1

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

• Samuel Olaniyi Bada, M.D.

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1770530586

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1689603755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 GLASS ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014625",
            "telephone_number": "731-424-2951",
            "fax_number": "731-424-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 GLASS ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014625",
            "telephone_number": "731-424-2951",
            "fax_number": "731-424-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD FOLKS MISSION CENTER,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "731-424-2951",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000175",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0445447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440140",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Convalescent Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derick Ogude, MD
• Chantel Okewole, PSY.D.
• Simon Olalekan Okewole, D.O.
• Chisom C Okpara
• Kyona Olatunji, NP
• Aleruchi Oleru, MD
• Chima O Oleru, MD
• Eric Marshall Olexa, CRNA
• Lisa Oliver, LPN
• Omni Visions, Inc

• Skilled Nursing Facility in Jackson, TN
• Providers in Jackson, 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 Feb 8, 2012; 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.