NPIMap

Organization Active NPI

Tallassee Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Tallassee, AL
National Provider Identifier
1992752745
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TALLASSEE HEALTH AND REHABILITATION, LLC
Practice address
2639 Gilmer Ave
Tallassee, AL 36078-7231
Phone
(334) 283-3975
NPI assigned
May 27, 2006
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2639 Gilmer Ave
Tallassee, AL 36078-7231

Mailing address

2639 Gilmer Ave
P. O. Box 780277
Tallassee, AL 36078-7231
Phone (334) 283-3975

Other identifiers 2

IdentifierTypeStateIssuer
014229OtherALBCBS ID
4753620SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030617000039 AL Part A Provider - Skilled Nursing Facility 8325958499 Practice locations: Tallassee, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992752745. Details of each certification follow.

Skilled nursing facility certification: CCN 015139

Legal name
TALLASSEE HEALTH AND REHABILITATION, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1976
Last certification
Nov 3, 2022
Beds
111
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jul 1, 2003
Organization structure
LLCProprietary
Enrollment address
2639 Gilmer Ave
Tallassee, AL 36078-7231
Nursing home name
TALLASSEE HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Tallassee Health and Rehabilitation, LLCCCN 015139 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
111105.0 residents per day on average
Chain
NHS Management43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Tallassee Health Realty LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Security Interest Jul 1, 2003
Millennium Health Operations, LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 8, 2002 100%
Julie H Richburg Individual Operational/Managerial ControlRegional Administrator Dec 11, 2014 33%
Managing Control - Governing BodyBoard Member Dec 11, 2014
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Oct 8, 2002 83.38%
Corporate OfficerPresident/Treasurer Oct 8, 2002 100%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Jennifer E Agee Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Sep 30, 2019 8.31%
Bryan K Baggett Individual Operational/Managerial Control May 27, 2024
Managing Control - Governing BodyBoard Member May 27, 2024
James N Estes Jr Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Sep 30, 2019 8.31%
Regions Bank Organization, Birmingham, AL Corporation, Financial institution, For-profit 5% Or Greater Security Interest Aug 27, 2012
Cameronesha N Nettles Individual Operational/Managerial Control Dec 16, 2024
Adp of the SNF Feb 7, 2025

Facilities with the same owner 23

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

View all 23

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.

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1992752745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 GILMER AVE",
            "address_2": "P. O. BOX 780277",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360787231",
            "telephone_number": "334-283-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 GILMER AVE",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360787231",
            "telephone_number": "334-283-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLASSEE HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "014229",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753620S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallassee, AL

Sources for this page

Verify at the official NPI Registry.