Organization Active NPI

The Waters of Robertson LLC

  • Skilled Nursing Facility
  • Springfield, TN
National Provider Identifier
1841744802
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE WATERS OF ROBERTSON LLC
Practice address
104 Watson Rd
Springfield, TN 37172-4510
Phone
(615) 384-9565
NPI assigned
Aug 8, 2016
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Moishe Gubin
Title
Member
Phone
(708) 449-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

104 Watson Rd
Springfield, TN 37172-4510

Mailing address

104 Watson Rd
Springfield, TN 37172-4510
Phone (615) 384-9565

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
44D0894408Waters of Robertson, LLC104 Watson Road, Springfield, TN 37172Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1841744802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WATSON RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724510",
            "telephone_number": "615-384-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WATSON RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724510",
            "telephone_number": "615-384-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERS OF ROBERTSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "GUBIN",
        "authorized_official_first_name": "MOISHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "708-449-1900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.