NPIMap

Organization Active NPI

Christian Care Center of Springfield LLC

Doing business as Christian Care Center Of Springfield

  • Skilled Nursing Facility
  • Springfield, TN
National Provider Identifier
1932183134
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000214 Issued in TN
Legal business name
CHRISTIAN CARE CENTER OF SPRINGFIELD LLC
Doing business as
Christian Care Center Of Springfield
Practice address
704 5TH Ave E
Springfield, TN 37172-2604
Phone
(615) 384-7977
Fax
(615) 382-1023
NPI assigned
Dec 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Jimmy R LewisNPI 1730831363
Title
Chief Manager
Phone
(423) 975-5455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0000000214 TN
Skilled Nursing Facility 314000000X 0000000214 TN Primary

Addresses

Primary practice location

704 5TH Ave E
Springfield, TN 37172-2604

Mailing address

704 5TH Ave E
Springfield, TN 37172-2604
Phone (615) 384-7977

Other identifiers 2

IdentifierTypeStateIssuer
0445480MedicaidTN
7440061MedicaidTN

Other names 1

  • Christian Care Center Of Springfield Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1932183134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 5TH AVE E",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371722604",
            "telephone_number": "615-384-7977",
            "fax_number": "615-382-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 5TH AVE E",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371722604",
            "telephone_number": "615-384-7977",
            "fax_number": "615-382-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CARE CENTER OF SPRINGFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "423-975-5455"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000214",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445480",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440061",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Care Center Of Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.