Active NPI
Overton County Health and Rehab Center
- Skilled Nursing Facility
- Livingston, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0000000200
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0445419 | Medicaid | TN | |
| 106838 | Other | TN | SKILLED NURSING FACILITY |
| 7440219 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Other
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - County
- Certified
- Jul 1, 2000
- Medicare certification status
- Active
- Certified beds
- 125
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0934351 | Overton County Health and Rehab Center | Certificate of waiver | Oct 5, 2027 |
National Provider Directory
National Provider DirectoryMember 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Darwin Clark | Managing Control - Governing Body | Aug 1, 2011 | |
| Donna Savage | Managing Control - Governing Body | Aug 1, 2011 | |
| Geraldine Walker | Managing Control - Governing Body | Oct 1, 2022 | |
| Overton County Ambulance Service | 5% Or Greater Direct Ownership Interest | Jan 1, 1966 | 100% |
| Adp of the SNF | Jul 1, 1961 | ||
| Jennifer Bouldin | Operational/Managerial Control | Jun 3, 2007 | |
| Adp of the SNF | Feb 26, 2007 | ||
| Randall Boswell | Managing Control - Governing Body | Aug 1, 2011 | |
| Charla Zalewski | Operational/Managerial Control | Feb 10, 2008 | |
| Adp of the SNF | Feb 10, 2008 | ||
| Jobe, Hasting & Associates Cpas, PLLC | Adp of the SNF | May 13, 2004 | |
| Michael T Cox | Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Mar 25, 2026 | ||
| Robbie Melton | 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.
-
- Internal Medicine Physician
- Livingston, TN
- NPI 1356305197
Adp of the SNF, Operational/Managerial Control
-
- Ambulance
- Livingston, TN
- NPI 1326019480
5% Or Greater Direct Ownership Interest, Adp of the SNF
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Livingston, TN
- NPI 1356305197
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.