NPIMap

Organization Active NPI

Sunbridge Regency - Tennessee LLC

  • Skilled Nursing Facility
  • La Follette, TN
National Provider Identifier
1881641389
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
00000019 Issued in TN
Legal business name
SUNBRIDGE REGENCY - TENNESSEE LLC
Practice address
136 Davis Lane
La Follette, TN 37766-3118
Phone
(423) 562-0760
Fax
(423) 562-6709
NPI assigned
May 28, 2006
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Michael T Berg
Title
Secretary
Phone
(610) 444-6350

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 00000019 TN
Skilled Nursing Facility 314000000X 00000019 TN Primary

Addresses

Primary practice location

136 Davis Lane
La Follette, TN 37766-3118

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 4

IdentifierTypeStateIssuer
702021736OtherCARITEN
7440435MedicaidTN
000155310OtherTNBLUE CROSS/BLUE SHIELD OF
0445276MedicaidTN

Other names 1

  • Cumberland Village Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070404000588 TN Part A Provider - Skilled Nursing Facility 9133223852 Practice locations: La Follette, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881641389. Details of each certification follow.

Skilled nursing facility certification: CCN 445276

Legal name
SUNBRIDGE REGENCY - TENNESSEE, LLC
Doing business as
CUMBERLAND VILLAGE CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 15, 1992
Last certification
Jan 14, 2025
Beds
182
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Genesis Healthcare
Organization structure
LLCProprietary
Incorporated
Jan 30, 2015 in TN
Enrollment address
136 Davis LN
La Follette, TN 37766-3118
Nursing home name
CUMBERLAND VILLAGE CARE
Affiliated entity
GENESIS HEALTHCARE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cumberland Village CareCCN 445276 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 15, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
182149.5 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain
Penalties (3 years)
1Fines totaling $18,769

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
44D0921140Cumberland Village Care & Rehabilitation Center136 Davis Lane, Lafollette, TN 37766Certificate of waiverOct 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sunbridge Regency - Tennessee LLC2 organizations share this tax ID, including this one
Part of
Sunrise HLTH Care Corp

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Laura Bridgeford Individual Corporate OfficerTreasurer Apr 1, 2024 100%
HCCF Management Group XI LLC Organization, Atlanta, GA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 10.8%
Gen Operations I LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 100%
Gen Operations II LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 100%
Sun Healthcare Group, Inc. Organization, Albuquerque, NM Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 65.3%
FC-Gen Operations Investment LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 100%
Organization, Kennett Square, PA LLC, Holding company Adp of the SNF Feb 6, 2025
Rob Flowers Individual Operational/Managerial Control Feb 23, 2017
Adp of the SNF Feb 23, 2017
Sundance Rehabilitation Holdco Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 5.2%
Elie Mansour Individual Operational/Managerial Control Apr 1, 2020
Adp of the SNF Jan 1, 2023
Genesis Healthcare LLC Organization, Kennett Square, PA LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 100%
Organization, Hunt Valley, MD For-profit Adp of the SNF Jan 1, 2021
Regency Health Services, LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 2, 2015 100%
Welltower Op, LLC Organization, Toledo, OH LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2024 5.7%
Arnold M Whitman Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 10.8%
Genesis Healthcare Inc Organization, Kennett Square, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 100%
Zac Properties XI LLC Organization, Philadelphia, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 7.6%
Steven E Fishman Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2012 7.6%
Organization, Kennett Square, PA LLC, For-profit Adp of the SNF Feb 6, 2025
Avi Pinchas Mendelson Individual Corporate OfficerPresident and Cfo Apr 1, 2024 100%
Michael T Berg Individual Corporate OfficerAssistant Secretary Dec 1, 2012 100%
Sunbridge Healthcare LLC Organization, Albuquerque, NM LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2008 100%
Genesis Holdings LLC Organization, Kennett Square, PA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 2, 2015 100%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 176

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

  • Sunbridge Regency - Tennessee, LLC

    dba Willow Ridge Center

    • Skilled Nursing Facility
    • Maynardville, TN
    • NPI 1871540385

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Regency Health Services, LLC, Sun Healthcare Group, Inc., Sunbridge

    CMS ownership
  • 1 Sutphin Drive Operations LLC

    dba Marmet Center

    • Skilled Nursing Facility
    • Marmet, WV
    • NPI 1538343710

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 100 Abbeyville Road Operations LLC

    dba Abbeyville Skilled Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Lancaster, PA
    • NPI 1467162172

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 100 Chambers Street Operations LLC

    dba Grandview Center

    • Skilled Nursing Facility
    • Cumberland, RI
    • NPI 1891977625

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 100 W Queen Street Operations LLC

    dba Dallastown Skilled Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Dallastown, PA
    • NPI 1336859040

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 1000 Lincoln Drive Operations LLC

    dba Valley Center

    • Skilled Nursing Facility
    • South Charleston, WV
    • NPI 1558545749

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 1008 Thompson Street Operations LLC

    dba Jersey Shore Skilled Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Jersey Shore, PA
    • NPI 1063122778

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 101 13TH Street Operations LLC

    dba Heritage Center

    • Skilled Nursing Facility
    • Huntington, WV
    • NPI 1912181223

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 1020 South Main Street Operations LLC

    dba Quakertown Center

    • Skilled Nursing Facility
    • Quakertown, PA
    • NPI 1588846893

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Zac Properties XI LLC

    CMS ownership
  • 106 Tyree Street Operations LLC

    dba Ansted Center

    • Skilled Nursing Facility
    • Ansted, WV
    • NPI 1639353816

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 1070 Stouffer Avenue Operations LLC

    dba Chambersburg Skilled Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Chambersburg, PA
    • NPI 1780394494

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Sundance Rehabilitation Holdco Inc, Welltower Op, LLC, Zac Properti

    CMS ownership
  • 11 Dairy Lane Operations LLC

    dba Woodmont Center

    • Skilled Nursing Facility
    • Fredericksburg, VA
    • NPI 1982885406

    FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare LLC, Genesis Holdings LLC, HCCF Management Group XI LLC, Zac Properties XI LLC

    CMS ownership
View all 176

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 4

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1881641389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 DAVIS LANE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377663118",
            "telephone_number": "423-562-0760",
            "fax_number": "423-562-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE REGENCY - TENNESSEE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-444-6350"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "00000019",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "00000019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARITEN",
            "identifier": "702021736",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440435",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF",
            "identifier": "000155310",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445276",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cumberland Village Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Follette, TN

Sources for this page

Verify at the official NPI Registry.