NPIMap

Organization Active NPI

Moundville Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Moundville, AL
National Provider Identifier
1831139898
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MOUNDVILLE HEALTH AND REHABILITATION, LLC
Practice address
121 Union St
Moundville, AL 35474
Phone
(205) 371-2252
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

121 Union St
Moundville, AL 35474

Mailing address

121 Union St
Moundville, AL 35474
Phone (205) 371-2252

Other identifiers 2

IdentifierTypeStateIssuer
012709OtherALBCBS ID
4754560SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030107000016 AL Part A Provider - Skilled Nursing Facility 6103734116 Practice locations: Moundville, AL

Skilled nursing facility certification: CCN 015187

Legal name
MOUNDVILLE HEALTH AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1977
Last certification
Oct 7, 2021
Beds
68
Ownership / control type
Corporation
Multi-facility organization
NHS Leasing and Consultin, LLC
Organization structure
LLCProprietary
Incorporated
Nov 8, 2002 in AL
Enrollment address
121 Union St
Moundville, AL 35474-4069
Nursing home name
MOUNDVILLE HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Moundville Health and Rehabilitation, LLCCCN 015187 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6864.9 residents per day on average
Chain
NHS Management43 facilities in the chain

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
01D0683060Moundville Health and Rehabilitation, LLC121 Union Street, Moundville, AL 35474Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Nov 8, 2002 5.32%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
NHS Facilities Group LLC Organization, Tuscaloosa, AL LLC, Holding company, For-profit 5% Or Greater Security Interest May 1, 2022
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Nov 8, 2002 5.32%
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Nov 8, 2002 89.36%
Corporate OfficerPresident/Treasurer Nov 8, 2002 100%
NHS Operations LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Direct Ownership Interest Nov 8, 2002 100%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Other Jan 1, 2022 10.64%
Brett Evans Milligan Individual W-2 Managing EmployeeAdministrator Feb 24, 2023 100%
Operational/Managerial ControlAdministrator Feb 24, 2023 100%
Casey D Boyd Individual Corporate DirectorRegional Administrator Apr 28, 2023 33%
Operational/Managerial ControlRegional Administrator Apr 28, 2023 33%
Regions Bank Organization, Birmingham, AL Corporation, Financial institution, For-profit 5% Or Greater Security Interest Aug 27, 2012 43.11%
Brandon S. Agee Individual Other Jan 1, 2022 10.64%
Marcia Duffy Individual Corporate DirectorRegional Nurse Consultant Dec 12, 2003 33%
Operational/Managerial ControlRegional Nurse Consultant Dec 12, 2003 33%
Moundville Health Realty, LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Security Interest Sep 12, 2008
NHS Management LLC Organization, Tuscaloosa, AL LLC, For-profit Other Jun 1, 2007
Servisfirst Bank Organization, Birmingham, AL Corporation, Financial institution, For-profit 5% Or Greater Security Interest May 1, 2022

Facilities with the same owner 40

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 40

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 1

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": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1831139898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 UNION ST",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "35474",
            "telephone_number": "205-371-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 UNION ST",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "35474",
            "telephone_number": "205-371-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDVILLE HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "012709",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4754560S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moundville, AL

Sources for this page

Verify at the official NPI Registry.