Organization Active NPI

Overton County Health and Rehab Center

  • Skilled Nursing Facility
  • Livingston, TN
National Provider Identifier
1790786614
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000200 Issued in TN
Legal business name
OVERTON COUNTY HEALTH AND REHAB CENTER
Practice address
318 Bilbrey St
Livingston, TN 38570-1706
Phone
(931) 823-6403
Fax
(931) 823-7836
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Mrs. Jennifer Bouldin, NHA
Title
Administrator
Phone
(931) 823-6403

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0000000200 TN
Skilled Nursing Facility 314000000X 0000000200 TN Primary

Addresses

Primary practice location

318 Bilbrey St
Livingston, TN 38570-1706

Mailing address

318 Bilbrey St
Livingston, TN 38570-1706
Phone (931) 823-6403

Other identifiers 3

IdentifierTypeStateIssuer
0445419MedicaidTN
106838OtherTNSKILLED NURSING FACILITY
7440219MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120119000116 TN Part A Provider - Skilled Nursing Facility 8325215106 Practice locations: Livingston, TN

Skilled nursing facility certification: CCN 445419

Legal name
OVERTON COUNTY HEALTH AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jul 1, 2000
Last certification
May 14, 2025
Beds
125
Ownership / control type
County
Organization structure
OtherNon-profit
Enrollment address
318 Bilbrey St
Livingston, TN 38570-1706
Nursing home name
OVERTON COUNTY HEALTH AND REHAB CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Overton County Health and Rehab CenterCCN 445419
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jul 1, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12579.4 residents per day on average

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
44D0934351Overton County Health and Rehab Center318 Bilbrey St, Livingston, TN 38570Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Darwin Clark Individual Managing Control - Governing Body Aug 1, 2011
Donna Savage Individual Managing Control - Governing Body Aug 1, 2011
Geraldine Walker Individual Managing Control - Governing Body Oct 1, 2022
Overton County Ambulance Service Organization, Livingston, TN 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Adp of the SNF Jul 1, 1961
Jennifer Bouldin Individual Operational/Managerial Control Jun 3, 2007
Adp of the SNF Feb 26, 2007
Randall Boswell Individual Managing Control - Governing Body Aug 1, 2011
Charla Zalewski Individual Operational/Managerial ControlController Feb 10, 2008
Adp of the SNF Feb 10, 2008
Jobe, Hasting & Associates Cpas, PLLC Organization, Murfreesboro, TN LLC Adp of the SNF May 13, 2004
Michael T Cox Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Mar 25, 2026
Robbie Melton Individual Managing Control - Governing Body Sep 1, 2021

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1790786614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 BILBREY ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701706",
            "telephone_number": "931-823-6403",
            "fax_number": "931-823-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 BILBREY ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701706",
            "telephone_number": "931-823-6403",
            "fax_number": "931-823-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERTON COUNTY HEALTH AND REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "BOULDIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-823-6403",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000200",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445419",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SKILLED NURSING FACILITY",
            "identifier": "106838",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440219",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TN

Sources for this page

Verify at the official NPI Registry.