Organization Active NPI

Clarksville Nursing and Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Clarksville, TN
National Provider Identifier
1790740462
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000189 Issued in TN
Legal business name
CLARKSVILLE NURSING AND REHABILITATION CENTER LLC
Practice address
900 Professional Park Drive
Clarksville, TN 37040
Phone
(931) 552-3002
Fax
(931) 647-8246
NPI assigned
Apr 18, 2006
Organization subpart
Yes
Parent organization
AMERICAN HEALTH COMPANIES, LLCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Ms. Robin F Bradley
Title
Secretary
Phone
(615) 595-8383

Facilities with the same owner 19

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

View all 19

Practitioners 2

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

Affiliated clinicians 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Meadows Post AcuteCCN 445455
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
113108.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050831000050 TN Part A Provider - Skilled Nursing Facility 5496786386 Practice locations: Clarksville, TN

Skilled nursing facility certification: CCN 445455

Legal name
CLARKSVILLE NURSING AND REHABILITATION CENTER LLC
Doing business as
AMERICAN HEALTH COMMUNITIES OF CLARKSVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 2002
Last certification
May 4, 2022
Beds
113
Ownership / control type
Corporation
Multi-facility organization
American Health Communities.
Most recent change of ownership
Jan 1, 2025
Organization structure
LLCProprietary
Incorporated
Mar 24, 1993 in TN
Enrollment address
900 Professional Park Dr
Clarksville, TN 37040-5244

All disclosed owners & managing parties 17

Medicare enrollment files

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

NameRoleSinceShare
Orchard Holdings LLC Organization, Birmingham, MI Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 47.07%
FLP Limited Partnership Organization, Tampa, FL Created for acquisition 5% Or Greater Indirect Ownership Interest Apr 6, 2021 100%
Mitchell Family Irrevocable Trust U/a Dated December 28, 2012 Organization, Birmingham, MI 5% Or Greater Indirect Ownership Interest Apr 6, 2021 23.54%
Robin Bradley Individual Corporate OfficerSecretary Apr 5, 2018
Corporate DirectorDirector Apr 5, 2018
Mitchell Family II Irrevocable Trust U/a Dated October 26, 2016 Organization, Birmingham, MI 5% Or Greater Indirect Ownership Interest Apr 6, 2021 11.77%
Ahp Orchards LLC Organization, Southfield, MI Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 93.32%
American Health Companies LLC Organization, Franklin, TN LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 26, 1993 100%
Mitchell Family III Irrevocable Trust U/a Dated July 14, 2017 Organization, Birmingham, MI 5% Or Greater Indirect Ownership Interest Apr 6, 2021 11.77%
Mfo Ahp LLC Organization, Birmingham, MI Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 99.02%
Ahpsnf Holdco LLC Organization, Franklin, TN Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 100%
Juanita Dufour Individual W-2 Managing EmployeeAdministrator Aug 15, 2022
Orchard Holdings II LLC Organization, Birmingham, MI Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 23.54%
Tennessee Health Management LLC Organization, Franklin, TN LLC, Management services company, For-profit Operational/Managerial Control Apr 1, 2012
Mark T Mitchell Individual 5% Or Greater Indirect Ownership Interest Apr 6, 2021 47.07%
Michael D Bailey Individual Corporate OfficerPresident and Ceo Sep 1, 2016
Corporate DirectorDirector Apr 1, 2016
Jeffrey Bogle Individual Corporate OfficerTreasurer/Chief Financial Office Apr 1, 2016
Corporate DirectorDirector Aug 25, 2018
Orchard Holdings III, LLC Organization, Birmingham, MI Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2021 23.54%

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0189 TN
Skilled Nursing Facility 314000000X 0000000189 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

900 Professional Park Drive
Clarksville, TN 37040

Mailing address

PO Box 10
Parsons, TN 38363-0010
Phone (731) 847-6343

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
744-0281MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 3, 2021.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1790740462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "PARSONS",
            "state": "TN",
            "postal_code": "383630010",
            "telephone_number": "731-847-6343",
            "fax_number": "731-847-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PROFESSIONAL PARK DRIVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-552-3002",
            "fax_number": "931-647-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE NURSING AND REHABILITATION CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN HEALTH COMPANIES, LLC",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-595-8383",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0189",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744-0281",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.