HQM of Ridgely, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0152 Issued in TN

Legal business name

HQM OF RIDGELY, LLC

Doing business as

Ridgely Care & Rehabilitation Center

Practice address

117 Main Street
Ridgely, TN 38080

Phone

(731) 264-5555

NPI assigned

Jan 19, 2006

Last updated

Sep 11, 2025By 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

Mr. Paul Walczak

Title

Ceo

Phone

(561) 627-0664

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ridgely Care & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1942280649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MAIN STREET",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "38080",
            "telephone_number": "731-264-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAIN STREET",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "38080",
            "telephone_number": "731-264-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HQM OF RIDGELY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WALCZAK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-627-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0152",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440548",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445327",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgely Care & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Citizens of Lake County for Health Care Inc (William B, Acree Clinic)
• Anna Davis, APRN
• Nettie Sue Hurst, NURSE PRACTITIONER
• LP Ridgely LLC (Signature HealthCARE of Ridgely Rehab & Wellness Center)
• Darin O'Shea Stites II, PA-C
• Taylor Bros Pharmacy LLC

• Nursing Facility/Intermediate Care Facility in Ridgely, TN
• Providers in Ridgely, TN by specialty
• Nursing Facility/Intermediate Care Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.