Country Living Skilled Nursing, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

251 E00000X Issued in OH

Legal business name

COUNTRY LIVING SKILLED NURSING, INC.

Practice address

7520 Ohio River
Portsmouth, OH 45662

Phone

(740) 574-4239

Fax

(740) 574-6347

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Linda K. Cunninham

Title

President

Phone

(740) 574-4239

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 368172

Legal name

COUNTRY LIVING SKILLED NURSING, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 30, 2006

Last certification

Oct 11, 2018

Ownership / control type

Proprietary

Organization structure

OtherProprietary

Incorporated

Sep 21, 2005 in OH

Enrollment address

7520 Ohio River Rd
Portsmouth, OH 45662-5669

Listed as

Country Living Skilled Nursing, IncCCN 368172 · All quality measures

Ownership

Proprietary

Certified

Nov 30, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Occupational therapy

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 4

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

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1962527176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 OHIO RIVER RD",
            "address_2": "PO BOX 215",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456625669",
            "telephone_number": "740-574-4239",
            "fax_number": "740-574-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 OHIO RIVER",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-574-4239",
            "fax_number": "740-574-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY LIVING SKILLED NURSING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "CUNNINHAM",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-574-4239",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "251 E00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachariah William Cornette, CDCA, QMHS
• Tiffany Cortez, CDCA
• Rachael L Cottrill, APRN, PMHNP-BC
• Karissa Couch, FNP-BC
• Country Living Home Care
• Tyler Counts
• Fred Courtney III, DO
• Jamie Courtney, LPN
• Raysha Cowan
• Erin Cox, COTA

• Home Health Agency in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.