Humphreys County Care and Rehabilitation
Organization Active NPI Skilled Nursing Facility · Waverly, TN
NPI 1881749596 · NPPES record last updated Jan 5, 2026
Key facts
- NPI
- 1881749596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0000000135 (TN)
- Legal business name
- HUMPHREYS COUNTY CARE AND REHABILITATION
- Practice address
- 104 Fort Hill Rd
Waverly, TN 37185-2128 - Phone
- (931) 296-2532
- Fax
- (931) 296-0829
- NPI assigned
- Jan 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Janet A Pulley, LNHA
- Title
- Administrator
- Phone
- (931) 296-2532
Practitioners 1
Affiliated clinicians 2
Medicare Care Compare: Nursing home
- Listed as
- Humphreys County Care and Rehabilitation
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Jan 1, 2009
- Medicare certification status
- Active
- Certified beds
- 91 · 69.6 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $14,013
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0904519 | Humphreys County Care and Rehab | Certificate of waiver | Aug 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Skilled nursing facility certification: CCN 445489
- Legal name
- HUMPHREYS COUNTY CARE AND REHABILITATION
- Doing business as
- HUMPHREYS COUNTY CARE & REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 2009
- Last certification
- Jun 5, 2024
- Beds
- 91
- Ownership / control type
- Other Nonprofit
- Organization structure
- Other · Non-profit
- Incorporated
- Aug 15, 1990 in TN
- Enrollment address
- 104 Fort Hill Rd
Waverly, TN 37185-2128 - Nursing home name
- HUMPHREYS COUNTY CARE AND REHABILITATION
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Jun 6, 2019 | |
| Janet Pulley |
Corporate Director |
Jun 1, 2024 | 100% |
| Operational/Managerial Control | Jun 1, 2024 | ||
| Adp of the SNF | Jun 1, 2024 | ||
| Humphreys County Care and Rehabilitation |
5% Or Greater Direct Ownership Interest | Jun 6, 2019 | 100% |
| Operational/Managerial Control | Jun 6, 2019 | ||
| Adp of the SNF | Jun 6, 2019 | ||
| Direct Ownership Interest | Jun 6, 2019 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081013000271 | TN | Part a Provider - Skilled Nursing Facility | 5799853164 | Practice locations: Waverly, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 0135 | TN | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0000000135 | TN | |
| Skilled Nursing Facility | 314000000X | 0000000135 | TN | Yes |
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
104 Fort Hill Rd
Waverly, TN 37185-2128
Mailing address
104 Fort Hill Rd
Waverly, TN 37185-2128
Phone (931) 296-2532
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7440099 | Medicaid | TN |
Other providers in Waverly, TN
- Della Teresa Hemphill
- Home Medical Care Inc
- Tammy R. Hooper
- Amy Paulette Horton
- Humphreys County Board of Education
- Humphreys County Community Health Services Inc
- Humphreys County Community Health Services, Inc.
- Humphreys County Community Health Services, Inc.
- Lawrence Richard Jackson Jr.
- James Developmental Center Inc.
All providers in Waverly, TN · Skilled Nursing Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.