NPIMap

Organization Active NPI

Smyrna Care Center

  • Skilled Nursing Facility
  • Smyrna, TN
National Provider Identifier
1790497667
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SMYRNA CARE CENTER
Practice address
200 Mayfield Dr
Smyrna, TN 37167-3019
Phone
(615) 355-0350
NPI assigned
Dec 22, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Brenda Campbell
Title
Ar Billing Manager
Phone
(859) 255-0075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

200 Mayfield Dr
Smyrna, TN 37167-3019

Mailing address

1050 Chinoe Rd Ste 350
Lexington, KY 40502-6571
Phone (859) 255-0075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230404002217 TN Part A Provider - Skilled Nursing Facility 3577938547 Practice locations: Smyrna, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790497667. Details of each certification follow.

Skilled nursing facility certification: CCN 445160

Legal name
SMYRNA CARE CENTER
Doing business as
EXCEPTIONAL LIVING CENTERS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 26, 1983
Last certification
Feb 26, 2020
Beds
125
Ownership / control type
Corporation
Multi-facility organization
Diversicare
Most recent change of ownership
Feb 1, 2023
Organization structure
LLCProprietary
Incorporated
Feb 1, 2023 in KY
Enrollment address
200 Mayfield Dr
Smyrna, TN 37167-3019
Nursing home name
SMYRNA CARE CENTER
Affiliated entity
EXCEPTIONAL LIVING CENTERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Smyrna Care CenterCCN 445160 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 26, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12593.5 residents per day on average
Chain
Exceptional Living Centers10 facilities in the chain
Penalties (3 years)
1Fines totaling $174,615

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
44D0861655Smyrna Care Center, LLC200 Mayfield Drive, Smyrna, TN 37167Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Amy H Watts Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 50%
Walter T Watts Individual 5% Or Greater Indirect Ownership InterestManager Feb 1, 2023 50%
Corporate OfficerPresident and Ceo Feb 1, 2023 100%
Adp of the SNF Feb 1, 2023
Brenda Campbell Individual Operational/Managerial Control Feb 1, 2023
Adp of the SNF Feb 1, 2023
Donald Vollmer Individual Managing Control - Governing BodyMedical Director Feb 1, 2023
Adp of the SNF Feb 1, 2023
Medical Rehabilitation Centers, LLC Organization, Lexington, KY LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2023 100%
Lexington Health Management LLC Organization, Lexington, KY LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 100%
Medical Rehabilitation Centers, LLC Organization, Lexington, KY Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2023 100%
Seleena Park Individual Operational/Managerial Control Jan 23, 2025
Managing Control - Governing BodyAdministrator Jan 23, 2025
Adp of the SNF Jan 23, 2025

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 9

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1790497667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 CHINOE RD STE 350",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405026571",
            "telephone_number": "859-255-0075",
            "fax_number": "859-281-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAYFIELD DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673019",
            "telephone_number": "615-355-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMYRNA CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "AR BILLING MANAGER",
        "authorized_official_telephone_number": "859-255-0075"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.