Christian Care Center of Rutherford County LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000221 Issued in TN

Legal business name

CHRISTIAN CARE CENTER OF RUTHERFORD COUNTY LLC

Practice address

202 Enon Springs Road East
Smyrna, TN 37167

Phone

(615) 459-5600

Fax

(615) 459-7022

NPI assigned

Jun 18, 2010

Organization subpart

No

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

Authorized official

Name

Lisa M. Cawood-Gray

Title

Risk Consultant

Phone

(423) 975-5455

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1811218324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 NORTHPARK",
            "address_2": "SUITE 2D",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043127",
            "telephone_number": "423-975-5455",
            "fax_number": "423-975-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ENON SPRINGS ROAD EAST",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-459-5600",
            "fax_number": "615-459-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CARE CENTER OF RUTHERFORD COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "CAWOOD-GRAY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "RISK CONSULTANT",
        "authorized_official_telephone_number": "423-975-5455"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000221",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445502",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440610",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Evelyn Chilcote
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• Christacare, LLC
• Jade Christopher
• CHS Medical
• Isabel Ruth Ciampa
• Devon Clapp
• Edwena Chenelle Clark, PTA

• Skilled Nursing Facility in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.