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COLLIERVILLE NURSING AND REHABILITATION
NPI 1114400975
Skilled Nursing Facility in Collierville, TN

Active since September 07, 2018CLIA 44D0679770 · Waiver
1/5
Overall Rating
490 W POPLAR AVE, COLLIERVILLE, TN 38017(901) 854-8506 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 9, 2024, Sep 7, 2018 (2 updates tracked since 2018).

About Collierville Nursing And Rehabilitation NPPES

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

COLLIERVILLE NURSING AND REHABILITATION (NPI 1114400975) is a healthcare organization registered as a skilled nursing facility in Collierville, Tennessee and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Mick Vujanovic, Ceo, as its authorized official.

NPPES Registry Identity

NPI1114400975
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCOLLIERVILLE NURSING AND REHABILITATION LLC
Location Address490 W POPLAR AVECollierville, TN 38017-2538
Mailing Address2100 Cherokee Ridge Way Ste 100Louisville, KY 40205-1600 · (502) 667-8150
Phone(901) 854-8506
Organization SubpartNo
Authorized OfficialMick VujanovicCeo · (502) 667-8150
Enumeration DateSeptember 7, 2018
Last NPPES UpdateOctober 9, 20242 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1114400975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedRespite CareTaxonomy 385H00000X
490 W POPLAR AVE, Collierville, TN 38017
Open in Google Maps ↗

Other Names 1

Doing Business AsCollierville Nursing And Rehabilitation

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.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 44D0679770

Collierville Nursing And Rehabilitation LLC Dba Collierville Nursing And Rehabilitation · Collierville, TN
Active · expires Aug 31, 2026
CLIA Number44D0679770
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorPollyanna Justice
Laboratory Phone(901) 854-8506
Laboratory LocationCollierville Nursing And Rehabilitation LLC Dba Collierville Nursing And Rehabilitation490 West Poplar Avenue, Collierville, TN 38017
CLIA data matches this NPI record on: Address Name Phone
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 Collierville Nursing And Rehabilitation, LLC (CMS certification number 445495), from CMS Care Compare.

Collierville Nursing And Rehabilitation, LLC

Nursing home · Collierville, TN
1/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number445495
Certified Beds114 beds86 residents per day on average
Medicare & Medicaid Participant SinceJuly 7, 2009
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
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.
67.33
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 1.79 · LPN 1.09 · RN 0.37
3.24 hrs per resident per day
Weekend Nurse Staffing
2.71 hrs per resident per day
Physical Therapist Staffing
0.07 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
71.3%
Registered Nurse Turnover
72.7%
Administrators Who Have Left
In the past year.
2
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
9
Fines
4 totaling $22,596.20
Medicare Payment Denials
2
Total Penalties
6
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 7

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

TAYLOR DAVIS
Nurse Practitioner (Family)
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (731) 394-1145
DR. FELESHA PERRY FNP-C
Nurse Practitioner (Family)
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (901) 488-0089
FMSC COLLIERVILLE OPERATING COMPANY LLC
Skilled Nursing Facility
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (901) 853-8561
MS. TONIE MULLEN FNP
Nurse Practitioner (Family)
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (901) 854-8506
POPLAR OAKS REHABILITATION AND HEALTHCARE CENTER, LLC
Skilled Nursing Facility
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (901) 854-8506
FMSC COLLIERVILLE OPERATING COMPANY
Skilled Nursing Facility
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (305) 892-1790
LATASHA CAROTHERS
Nurse Practitioner (Family)
490 W POPLAR AVE
COLLIERVILLE, TN 38017
Shelby County (731) 394-1145

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 Collierville Nursing And Rehabilitation LLC's NPI number?

The NPI number for Collierville Nursing And Rehabilitation LLC is 1114400975. It was assigned to this organization in the NPPES registry on September 7, 2018. The provider is doing business as Collierville Nursing And Rehabilitation.

Where is Collierville Nursing And Rehabilitation LLC located?

Collierville Nursing And Rehabilitation LLC is located at 490 W Poplar Ave, Collierville, TN 38017. The listed phone number is (901) 854-8506.

What is Collierville Nursing And Rehabilitation LLC's specialty?

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

Does Collierville Nursing And Rehabilitation LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0679770) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Collierville Nursing And Rehabilitation LLC a Medicare-certified nursing home?

Yes. Collierville Nursing And Rehabilitation, LLC is a Medicare-certified nursing home with 114 certified beds.

What quality rating does Collierville Nursing And Rehabilitation LLC have?

CMS rates Collierville Nursing And Rehabilitation, LLC 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Collierville Nursing And Rehabilitation LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 4 other insurers list Collierville Nursing And Rehabilitation LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Collierville Nursing And Rehabilitation LLC was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.