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REGENCY RETIREMENT VILLAGE
NPI 1073814893
Assisted Living Facility in Jackson, TN

Active since November 10, 2010CLIA 44D2196410 · Waiver
420 CHEYENNE DR, JACKSON, TN 38305(731) 661-9888(731) 661-9056 Get Directions Write a Review

NPPES record last updated: November 10, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Regency Retirement Village NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REGENCY RETIREMENT VILLAGE (NPI 1073814893) is a healthcare organization registered as an assisted living facility in Jackson, Tennessee and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through October 15, 2026 and lists Matthew A Ernst, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1073814893
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameJACKSON SENIOR SERVICES, LLC
Location Address420 CHEYENNE DRJackson, TN 38305-5412
Mailing Address420 Cheyenne DrJackson, TN 38305-5412 · (731) 661-9888 · Fax (731) 661-9056
Phone(731) 661-9888
Fax(731) 661-9056
Organization SubpartNo
Authorized OfficialMatthew A ErnstExecutive Director · (731) 661-9888
Enumeration DateNovember 10, 2010
✔ NPI 1073814893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in TN · ACL0000000124
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License ACL0000000124 (TN)
Also ListedRespite CareTaxonomy 385H00000X · License ACL0000000124 (TN)
420 CHEYENNE DR, Jackson, TN 38305
Open in Google Maps ↗

Other Names 1

Doing Business AsRegency Retirement Village

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2196410

Regency Retirement Village · Jackson, TN
Active · expires Oct 15, 2026
CLIA Number44D2196410
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 16, 2024
Certificate Expiration DateOctober 15, 2026
Laboratory DirectorCarol C. Wright
Laboratory Phone(731) 661-9888
Laboratory LocationRegency Retirement Village420 Cheyenne Drive, Jackson, TN 38305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Senior Services, LLC's NPI number?

The NPI number for Jackson Senior Services, LLC is 1073814893. It was assigned to this organization in the NPPES registry on November 10, 2010. The provider is doing business as Regency Retirement Village.

Where is Jackson Senior Services, LLC located?

Jackson Senior Services, LLC is located at 420 Cheyenne Dr, Jackson, TN 38305. The listed phone number is (731) 661-9888.

What is Jackson Senior Services, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Jackson Senior Services, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2196410) is associated with this NPI, valid through October 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jackson Senior Services, LLC was last updated on November 10, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.