HOLSTON MANOR
NPI 1356504393
Skilled Nursing Facility in Kingsport, TN

Active since July 09, 2008CLIA 44D0311171 · Waiver
3641 MEMORIAL BLVD, KINGSPORT, TN 37664(423) 246-2411(423) 246-8997 Get Directions Write a Review

NPPES record last updated: May 13, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Holston Manor NPPES

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

HOLSTON MANOR (NPI 1356504393) is a healthcare organization registered as a skilled nursing facility in Kingsport, Tennessee and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through December 15, 2026 and lists Rhonda B Nelson, Controller, as its authorized official.

NPPES Registry Identity

NPI1356504393
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHOLSTON NH OPERATIONS LLC
Location Address3641 MEMORIAL BLVDKingsport, TN 37664-3422
Mailing Address3641 Memorial BlvdKingsport, TN 37664-3422 · (423) 246-2411 · Fax (423) 246-8997
Fax(423) 246-8997
Organization SubpartNo
Authorized OfficialRhonda B NelsonController · (864) 578-6599
Enumeration DateJuly 9, 2008
Last NPPES UpdateMay 13, 2015
NPI 1356504393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in TN · 0000000264
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.
3641 MEMORIAL BLVD, Kingsport, TN 37664

Other Names 1

Doing Business AsHolston Manor

Other Identifiers 4

Medicaid0445295TN
Medicaid7440436TN
Medicare NSC6191590001TN
Medicare OSCAR/certification445295TN

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 44D0311171

Holston Manor Snf Operations LLC Dba Holston Rehabilitation And Care Center · Kingsport, TN
Active · expires Dec 15, 2026
CLIA Number44D0311171
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateDecember 16, 2024
Certificate Expiration DateDecember 15, 2026
Laboratory DirectorAngela Sumner
Laboratory Phone(423) 246-2411
Laboratory LocationHolston Manor Snf Operations LLC Dba Holston Rehabilitation And Care Center3641 Memorial Blvd, Kingsport, TN 37664
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Nursing Facility/Intermediate Care Facility
3641 MEMORIAL BLVD
KINGSPORT, TN 37664
Skilled Nursing Facility
3641 MEMORIAL BLVD
KINGSPORT, TN 37664
Skilled Nursing Facility
3641 MEMORIAL BLVD
KINGSPORT, TN 37664
Occupational Therapist
3641 MEMORIAL BLVD
KINGSPORT, TN 37664

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 Holston Nh Operations LLC's NPI number?

The NPI number for Holston Nh Operations LLC is 1356504393. It was assigned to this organization in the NPPES registry on July 9, 2008. The provider is doing business as Holston Manor.

Where is Holston Nh Operations LLC located?

Holston Nh Operations LLC is located at 3641 Memorial Blvd, Kingsport, TN 37664. The listed phone number is (423) 246-2411.

What is Holston Nh Operations LLC's specialty?

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

Does Holston Nh Operations LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0311171) is associated with this NPI, valid through December 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 Holston Nh Operations LLC was last updated on May 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.