Buffalo Valley, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0000000072 Issued in TN

Legal business name

BUFFALO VALLEY, INC.

Practice address

501 Park Ave S
Hohenwald, TN 38462-1835

Phone

(931) 796-4256

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jerry T Risner

Title

Executive Director

Phone

(931) 796-4256

Specialties & licenses 12

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen L Averett, M.D.

  • Internal Medicine Physician
  • Linden, TN
  • NPI 1063512390
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1710074083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PARK AVE S",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384621835",
            "telephone_number": "931-796-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PARK AVE S",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384621835",
            "telephone_number": "931-796-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO VALLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "RISNER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "931-796-4256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000072",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000071",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000383",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000401",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000170",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000428",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "0000000396",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "0000000072",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "0000000071",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "0000000076",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "0000000401",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TN",
            "license": "0000000428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Jill Banks, MA
• Sara Barber, PTA
• Tonia Barrier, RN
• Jenny Brewer
• Jennifer Lauren Broadrick
• Amy Elizabeth Burks, NP-C
• John Burton
• Donna Butler, FNP
• Candice Campbell, APN
• Iris Echavez Carroll

• All providers in Hohenwald, TN
• Substance Abuse Rehabilitation Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.