Restoration House Ministries

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

RESTORATION HOUSE MINISTRIES

Practice address

2450 Winfield Dunn Pkwy
Kodak, TN 37764-2100

Phone

(865) 805-0567

NPI assigned

Sep 15, 2022

Last updated

Feb 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Johnson, M.A., M.DIVNPI 1467179929

Title

Ceo

Phone

(865) 805-0567

Specialties & licenses 6

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Johnson, M.A., M.DIV

  • Addiction (Substance Use Disorder) Counselor
  • Kodak, TN
  • NPI 1467179929
  Authorized official Same address or phone

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1821710864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 WINFIELD DUNN PKWY",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377642100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 WINFIELD DUNN PKWY",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377642100",
            "telephone_number": "865-805-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HOUSE MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-805-0567",
        "authorized_official_credential": "M.A., M.DIV"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nationalrx, Inc
• Saman Perera
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• Premier Care Medical
• Restoration House Ministries
• Joseph Roberto, DDS
• Svetlana Rowland, FNP-BC
• Noelan Schafer
• Deborah Clay Sellers-Mooney, FNP-BC
• TN Premier Care LLC

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Kodak, TN
• Providers in Kodak, TN by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.