Cloverdale Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10541 Issued in AL

Legal business name

CLOVERDALE HEALTH CARE, INC.

Doing business as

Cloverdale Rehabilitation and Nursing Center

Practice address

412 W Cloverdale Rd
Scottsboro, AL 35768-4264

Phone

(256) 259-1505

Fax

(256) 259-4279

NPI assigned

Jun 24, 2005

Last updated

Jun 6, 2017By 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

Mrs. Kristy A Jones, LNHA

Title

Administrator

Phone

(256) 259-1505

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cloverdale Rehabilitation and Nursing Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922004811. Details of each certification follow.

• CCN 015184 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 015184

Legal name

CLOVERDALE HEALTH CARE, INC.

Doing business as

CLOVERDALE REHABILITATION AND NURSING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1977

Last certification

Mar 31, 2022

Beds

141

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Enrollment address

412 W Cloverdale Rd
Scottsboro, AL 35768-4264

Nursing home name

CLOVERDALE REHABILITATION AND WELLNESS

Affiliated entity

TRINITY MANAGEMENT, INC.

Listed as

Cloverdale Rehabilitation and WellnessCCN 015184 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

141121.9 residents per day on average

Chain

Trinity Management, Inc.5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 12

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

Owners & managing parties with NPI records 1

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

• Cheryl C Bazzle, M.D.

  • Specialist
  • Huntsville, AL
  • NPI 1942419643

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

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

• Altoona Health & Rehab, Inc.

  dba Altoona Health & Rehab

  • Skilled Nursing Facility
  • Altoona, AL
  • NPI 1609868595

  Trintiy Management, Inc.

  CMS ownership
• DHS of Blount County, LLC

  dba TLC Nursing Center

  • Skilled Nursing Facility
  • Oneonta, AL
  • NPI 1134111081

  Trintiy Management, Inc.

  CMS ownership
• St. Clair Health & Rehab, Inc.

  dba St Clair Health & Rehab

  • Skilled Nursing Facility
  • Pell City, AL
  • NPI 1669558086

  Trintiy Management, Inc.

  CMS ownership

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.

• Cheryl C Bazzle, M.D.

  • Specialist
  • Huntsville, AL
  • NPI 1942419643
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Cheryl C Bazzle, M.D.

  • Specialist
  • Huntsville, AL
  • NPI 1942419643

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496707200000",
    "number": "1922004811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W CLOVERDALE RD",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684264",
            "telephone_number": "256-259-1505",
            "fax_number": "256-259-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CLOVERDALE RD",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684264",
            "telephone_number": "256-259-1505",
            "fax_number": "256-259-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2017-06-06",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-259-1505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "10541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "011620",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753350S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cloverdale Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cloverdale Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dakota Ellis Clark, FNP
• Melinda Pace Clark, L.C.S.W.
• Christopher Brian Clayton, M.D.
• Whitney Claridy Clayton, CRNP
• Brandy S Clemons, PT
• Cloverdale SNF Opco LLC (Cloverdale Rehabilitation and Wellness)
• Pamela M Cobb, M.A.
• William Hardin Coleman Jr., M.D.
• Dawson Staley Colvert, DDS
• Lauren Elizabeth Combs

• Skilled Nursing Facility in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.