LP South Pittsburg LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

176 Issued in TN

Legal business name

LP SOUTH PITTSBURG LLC

Doing business as

Signature HealthCARE of South Pittsburg Rehab & Wellness Center

Practice address

201 E 10TH St
South Pittsburg, TN 37380-1497

Phone

(423) 837-7981

Fax

(423) 837-1814

NPI assigned

Aug 1, 2007

Last updated

Apr 4, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

LP CR HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Mr. John Harrison

Title

Cfo

Phone

(502) 568-7800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Signature HealthCARE of South Pittsburg Rehab & Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942490255. Details of each certification follow.

• CCN 445343 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445343

Legal name

LP SOUTH PITTSBURG LLC

Doing business as

SIGNATURE HEALTHCARE OF SOUTH PITTSBURG REHAB & WELLNESS CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 1995

Last certification

Oct 16, 2024

Beds

165

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Signature Health Care

Most recent change of ownership

Nov 1, 2007

Organization structure

LLCProprietary

Incorporated

May 20, 2008 in DE

Enrollment address

201 E 10TH St
South Pittsburg, TN 37380-1497

Nursing home name

SIGNATURE HEALTHCARE OF SOUTH PITTSBURG REHAB & WE

Affiliated entity

SIGNATURE HEALTHCARE

Listed as

Signature Healthcare of South Pittsburg Rehab & WeCCN 445343 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

16576.8 residents per day on average

Chain

Signature Healthcare67 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $20,050

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 10

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

Facilities with the same owner 64

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

• LP Byrdstown LLC

  dba Pickett Care & Rehabilitation Center

  • Nursing Facility/Intermediate Care Facility
  • Byrdstown, TN
  • NPI 1407047798

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Clarksville LLC

  dba Signature HealthCARE of Clarksville

  • Nursing Facility/Intermediate Care Facility
  • Clarksville, TN
  • NPI 1891985131

  Jjla LLC, Wheaten LLC

  CMS ownership
• LP Cleveland LLC

  dba Signature HealthCARE of Cleveland

  • Nursing Facility/Intermediate Care Facility
  • Cleveland, TN
  • NPI 1508057456

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Cookeville, LLC

  dba Signature HealthCARE of Putnam County

  • Skilled Nursing Facility
  • Cookeville, TN
  • NPI 1144645870

  Jjla LLC, Wheaten LLC

  CMS ownership
• LP Elizabethton LLC

  dba Signature HealthCARE of Elizabethton Rehab & Wellness Center

  • Nursing Facility/Intermediate Care Facility
  • Elizabethton, TN
  • NPI 1255521555

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Erin LLC

  dba Signature HealthCARE of Erin

  • Nursing Facility/Intermediate Care Facility
  • Erin, TN
  • NPI 1457541872

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Greeneville LLC

  dba Signature HealthCARE of Greeneville

  • Nursing Facility/Intermediate Care Facility
  • Greeneville, TN
  • NPI 1699966986

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Jamestown LLC

  dba Signature HealthCARE of Fentress County

  • Nursing Facility/Intermediate Care Facility
  • Jamestown, TN
  • NPI 1174713598

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Johnson City, LLC

  dba Princeton Transitional Care & Assisted Living

  • Skilled Nursing Facility
  • Johnson City, TN
  • NPI 1043798424

  Jjla LLC, Wheaten LLC

  CMS ownership
• LP Memphis LLC

  dba Signature HealthCARE of Memphis

  • Nursing Facility/Intermediate Care Facility
  • Memphis, TN
  • NPI 1831380120

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership
• LP Memphis V, LLC

  dba Signature HealthCARE of Primacy

  • Skilled Nursing Facility
  • Memphis, TN
  • NPI 1760898415

  Jjla LLC, Wheaten LLC

  CMS ownership
• LP Monteagle LLC

  dba Signature HealthCARE of Monteagle Rehab & Wellness Center

  • Nursing Facility/Intermediate Care Facility
  • Monteagle, TN
  • NPI 1528259561

  Agemo Holdings LLC, Jjla LLC, LP CR Holdings LLC, Lpsnf II LLC, Wheaten LLC

  CMS ownership

Practitioners 2

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.

• Karin B Boeck, M.D.

  • Family Medicine Physician
  • Kimball, TN
  • NPI 1104817774
  NPD (past)
• Charlie Weichin Fang, MD

  • Family Medicine Physician
  • Whitwell, TN
  • NPI 1609962521
  NPD (past)

Affiliated clinicians 1

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

• Karin B Boeck, M.D.

  • Family Medicine Physician
  • Kimball, TN
  • NPI 1104817774

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1942490255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PARKWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800",
            "fax_number": "502-568-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 10TH ST",
            "city": "SOUTH PITTSBURG",
            "state": "TN",
            "postal_code": "373801497",
            "telephone_number": "423-837-7981",
            "fax_number": "423-837-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP SOUTH PITTSBURG LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LP CR HOLDINGS LLC",
        "enumeration_date": "2007-08-01",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "176",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "176",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445343",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440312",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature HealthCARE of South Pittsburg Rehab & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Signature HealthCARE of South Pittsburg Rehab & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah M Kittle, NURSE PRACTITIONER
• Christina Landowski, FNP-C
• Emily Pittman Layne, BS
• Karen Marie Leblanc, O.D.
• George Harold Lloyd Jr., OD
• Charles Taylor Millirons III, MD
• One to One Health PLLC
• Cari Beth Page, MD
• Pediatric Specialists of Marion County PLLC
• Kathy Cartwright Philyaw, MD

• Nursing Facility/Intermediate Care Facility in South Pittsburg, TN
• Providers in South Pittsburg, 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 Apr 4, 2023; 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.