Organization Active NPI

Bradley County Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Cleveland, TN
National Provider Identifier
1801884010
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
BRADLEY COUNTY NURSING HOME
Practice address
2910 Peerless Rd NW
Cleveland, TN 37312-3742
Phone
(423) 472-7116
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Mr. Joseph H Newcomb
Title
Administrator
Phone
(423) 472-7116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

2910 Peerless Rd NW
Cleveland, TN 37312-3742

Mailing address

2910 Peerless Rd NW
Cleveland, TN 37312-3742
Phone (423) 472-7116

Other identifiers 4

IdentifierTypeStateIssuer
0345040001OtherTNDEMERC/PALMETTO
7440017MedicaidTN
0345040001OtherTNDME MAC JURISDICTION C
0445141MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203001164 TN Part A Provider - Skilled Nursing Facility 9032306949 Practice locations: Cleveland, TN

Skilled nursing facility certification: CCN 445141

Legal name
BRADLEY COUNTY NURSING HOME
Doing business as
BRADLEY HEALTHCARE & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 22, 1981
Last certification
Nov 2, 2022
Beds
213
Ownership / control type
Corporation
Organization structure
Not SelectedProprietary
Enrollment address
2910 Peerless Road NW
Cleveland, TN 37312-3742
Nursing home name
BRADLEY HEALTH CARE & REHAB

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bradley Health Care & RehabCCN 445141
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 22, 1981
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
21398.3 residents per day on average
Penalties (3 years)
1Fines totaling $8,999

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
44D0963567Bradley Healthcare & Rehabilitation2910 Peerless Road, Cleveland, TN 37312Certificate of waiverAug 2, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
John Stanbery Individual Corporate Officer Mar 18, 2013
Dennis Burtnett Individual Corporate Officer Apr 1, 2012
Erin Fuller Individual Corporate Officer Jan 1, 2011
William Winters Individual Corporate Officer Feb 1, 2011
Robert Rominger Individual Corporate Officer Aug 1, 2012
Deborah Crabtree Individual W-2 Managing Employee Mar 3, 2010
Sandra Jo Snider Individual Corporate Officer Mar 18, 2013
Wendy Beck Individual Corporate Officer Mar 18, 2013
Judy Gee Individual Corporate Officer Mar 18, 2013

Owners & managing parties with NPI records 3

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1801884010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 PEERLESS RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123742",
            "telephone_number": "423-472-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 PEERLESS RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123742",
            "telephone_number": "423-472-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "NEWCOMB",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-472-7116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERC/PALMETTO",
            "identifier": "0345040001",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440017",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC JURISDICTION C",
            "identifier": "0345040001",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445141",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.