ANDERSONVILLE TN OPCO, LLC
NPI 1083357628
Skilled Nursing Facility in Andersonville, TN

Q: What is Andersonville Tn Opco, LLC's NPI number?

The NPI number for Andersonville Tn Opco, LLC is 1083357628. It was assigned to this organization in the NPPES registry on April 20, 2022.

Q: What is Andersonville Tn Opco, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Q: What quality rating does Andersonville Tn Opco, LLC have?

CMS rates Andersonville Tn Opco LLC 2 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Active since April 20, 2022CLIA 44D0674318 · Waiver

2/5

Overall Rating

3382 ANDERSONVILLE HWY, ANDERSONVILLE, TN 37705(773) 870-7818 Get Directions Write a Review

NPPES record last updated: February 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 7, 2023, Apr 20, 2022 (2 updates tracked since 2022).

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About Andersonville Tn Opco, Llc NPPES

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

ANDERSONVILLE TN OPCO, LLC (NPI 1083357628) is a healthcare organization registered as a skilled nursing facility in Andersonville, Tennessee and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David Rubinstein, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1083357628

Entity TypeOrganization

Primary Taxonomy314000000X

Legal Business NameANDERSONVILLE TN OPCO, LLC

Location Address3382 ANDERSONVILLE HWYAndersonville, TN 37705-3816

Mailing Address23645 Mercantile Rd Ste JBeachwood, OH 44122-5936 · (646) 649-0478

Phone(773) 870-7818

Organization SubpartNo

Authorized OfficialDavid RubinsteinChief Financial Officer · (212) 444-1991

Enumeration DateApril 20, 2022

Last NPPES UpdateFebruary 7, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 7, 2023

✔ NPI 1083357628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities

Taxonomy Code314000000X

Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

3382 ANDERSONVILLE HWY, Andersonville, TN 37705

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

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 44D0674318

Andersonville Tn Opco LLC · Andersonville, TN

Active · expires Aug 31, 2026

CLIA Number44D0674318

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorTrent Mcneeley MD

Laboratory Phone(865) 494-0986

Laboratory LocationAndersonville Tn Opco LLC3382 Andersonville Hwy, Andersonville, TN 37705

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Andersonville Tn Opco LLC (CMS certification number 445303), from CMS Care Compare.

Andersonville Tn Opco LLC

Nursing home · Andersonville, TN

2/5 CMS Overall Rating

OwnershipFor profit - Corporation

CMS Certification Number445303

Certified Beds103 beds77 residents per day on average

Medicare & Medicaid Participant SinceDecember 1, 1992

Resident & Family CouncilResident council

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

4/5

Long-Stay Quality

Quality of care delivered to long-term residents.

5/5

Short-Stay Quality

Quality of care delivered to short-term and rehabilitation residents.

3/5

Staffing

Based on nursing staff hours relative to resident needs.

1/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 1.72 · LPN 0.93 · RN 0.66

3.3 hrs per resident per day

Weekend Nurse Staffing

2.48 hrs per resident per day

Physical Therapist Staffing

0.03 hrs per resident per day

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents

Substantiated Complaints

Infection-Control Citations

Fines

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER LEANN PRESCOTT AGNP-C

Clinic/Center (Multi-Specialty)