NPIMap

Organization Active NPI

The Waters of Smyrna LLC

  • Skilled Nursing Facility
  • Smyrna, TN
National Provider Identifier
1982157434
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE WATERS OF SMYRNA LLC
Practice address
202 Enon Springs Rd E
Smyrna, TN 37167-3011
Phone
(615) 459-5600
Fax
(615) 355-5884
NPI assigned
Aug 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Authorized official

Name
Moishe Gubin
Title
Member
Phone
(708) 449-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

202 Enon Springs Rd E
Smyrna, TN 37167-3011

Mailing address

202 Enon Springs Rd E
Smyrna, TN 37167-3011
Phone (615) 459-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161024001832 TN Part A Provider - Skilled Nursing Facility 7911285184 Practice locations: Smyrna, TN

Skilled nursing facility certification: CCN 445502

Legal name
THE WATERS OF SMYRNA, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 24, 2011
Last certification
Aug 10, 2022
Beds
91
Ownership / control type
Limited Liability Corporation
Multi-facility organization
na
Most recent change of ownership
Aug 1, 2016
Organization structure
LLCProprietary
Enrollment address
202 Enon Springs Rd E
Smyrna, TN 37167-3011
Nursing home name
THE WATERS OF SMYRNA, LLC
Affiliated entity
INFINITY HEALTHCARE CONSULTING

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Waters of Smyrna, LLCCCN 445502
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 24, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9168.2 residents per day on average
Chain
Infinity Healthcare Consulting69 facilities in the chain
Penalties (3 years)
2Fines totaling $97,773

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2010864Waters of Smyrna, the202 Enon Springs Rd East, Smyrna, TN 37167Certificate of waiverAug 5, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Gubin Enterprises Limited Partnership Organization, South Bend, IN 5% Or Greater Direct Ownership Interest Aug 1, 2016 50%
Michael Blisko Individual 5% Or Greater Direct Ownership Interest Aug 1, 2016 50%
Alan a Hall Individual W-2 Managing EmployeeAdministrator Feb 21, 2023

Facilities with the same owner 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1982157434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ENON SPRINGS RD E",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673011",
            "telephone_number": "615-459-5600",
            "fax_number": "615-355-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ENON SPRINGS RD E",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673011",
            "telephone_number": "615-459-5600",
            "fax_number": "615-355-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERS OF SMYRNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "GUBIN",
        "authorized_official_first_name": "MOISHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "708-449-1900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.