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ABUNDANT CHRISTIAN LIVING COMMUNITY LLC
NPI 1902491178
Skilled Nursing Facility in Johnson City, TN

Active since March 09, 2021CLIA 44D0310573 · Waiver
3/5
Overall Rating
2012 SHERWOOD DR, JOHNSON CITY, TN 37601(423) 232-8200(423) 232-8240 Get Directions Write a Review

NPPES record last updated: March 10, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Abundant Christian Living Community Llc NPPES

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

ABUNDANT CHRISTIAN LIVING COMMUNITY LLC (NPI 1902491178) is a healthcare organization registered as a skilled nursing facility in Johnson City, Tennessee and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jimmy R. Lewis, Chief Manager, as its authorized official.

NPPES Registry Identity

NPI1902491178
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameABUNDANT CHRISTIAN LIVING COMMUNITY LLC
Location Address2012 SHERWOOD DRJohnson City, TN 37601-3238
Mailing Address2020 Northpark Dr Ste 2dJohnson City, TN 37604-3127 · (423) 975-5455 · Fax (423) 390-0743
Phone(423) 232-8200
Fax(423) 232-8240
Organization SubpartNo
Authorized OfficialJimmy R. LewisChief Manager · (423) 975-5455
Enumeration DateMarch 9, 2021
Last NPPES UpdateMarch 10, 2021
NPPES CertifiedMarch 10, 2021
✔ NPI 1902491178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedAssisted Living FacilityTaxonomy 310400000X
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X
2012 SHERWOOD DR, Johnson City, TN 37601
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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 44D0310573

Abundant Christian Living Community, LLC · Johnson City, TN
Active · expires Aug 31, 2026
CLIA Number44D0310573
Laboratory TypeCcrc Community Snf, Alf
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSherry Starnes
Laboratory Phone(423) 232-8200
Laboratory LocationAbundant Christian Living Community, LLC2012 Sherwood Drive, Johnson City, TN 37601
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 Abundant Christian Living Community Rehabilitation (CMS certification number 445483), from CMS Care Compare.

Abundant Christian Living Community Rehabilitation

Nursing home · Johnson City, TN
3/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number445483
Certified Beds103 beds91 residents per day on average
Medicare & Medicaid Participant SinceJanuary 1, 2007
Resident & Family CouncilResident council
Continuing care retirement community 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.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
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.
11.33
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 1.71 · LPN 1.02 · RN 0.33
3.06 hrs per resident per day
Weekend Nurse Staffing
2.72 hrs per resident per day
Physical Therapist Staffing
0.04 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
44.4%
Registered Nurse Turnover
50%
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
3
Infection-Control Citations
1
Fines
1 totaling $64,564.50
Medicare Payment Denials
0
Total Penalties
1
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 2

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

MRS. CHRISTINA POLLY M.S., CCC-SLP
Speech-Language Pathologist
2012 SHERWOOD DR
JOHNSON CITY, TN 37601
Washington County (877) 584-3412
JESSICA SHIRLEY SLP
Speech-Language Pathologist
2012 SHERWOOD DR
JOHNSON CITY, TN 37601
Washington County (423) 232-8200

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 Abundant Christian Living Community LLC's NPI number?

The NPI number for Abundant Christian Living Community LLC is 1902491178. It was assigned to this organization in the NPPES registry on March 9, 2021.

Where is Abundant Christian Living Community LLC located?

Abundant Christian Living Community LLC is located at 2012 Sherwood Dr, Johnson City, TN 37601. The listed phone number is (423) 232-8200.

What is Abundant Christian Living Community LLC's specialty?

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

Does Abundant Christian Living Community LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0310573) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Abundant Christian Living Community LLC a Medicare-certified nursing home?

Yes. Abundant Christian Living Community Rehabilitation is a Medicare-certified nursing home with 103 certified beds.

What quality rating does Abundant Christian Living Community LLC have?

CMS rates Abundant Christian Living Community Rehabilitation 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Abundant Christian Living Community 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 3 other insurers list Abundant Christian Living Community 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 Abundant Christian Living Community LLC was last updated on March 10, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.