MEDICARE: COMMUNITY CARE OF RUTHERFORD COUNTY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BN1400X	Nursing Facility Supplies (DME)		TN
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)		TN
3	314000000X	Skilled Nursing Facility	0000000219	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4100484	OTHER	TN	BLUECROSS ALLIED PROVIDER
4	3110468	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1508866898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CARE OF RUTHERFORD COUNTY, INC.

Provider Business Mailing Address
First Line	:	901 EAST COUNTY FARM RD
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37127-6328
Country	:	US
Telephone Number	:	615-893-2624
Fax Number	:	615-898-7989

Provider Business Practice Location Address
First Line	:	901EAST COUNTY FARM RD
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37127-6328
Country	:	US
Telephone Number	:	615-893-2624
Fax Number	:	615-898-7989

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARK KING
Credential	:
Telephone Number	:	615-893-2624

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	11/26/2008

Similar Medicare Providers

1447914486 — MRS. ASHLYN SMITH M.A., CCC-SLP
Practice Location Address:

901 COUNTY FARM RD
MURFREESBORO, TN
37127-6328

Practice Phone: 615-893-2624
Practice Fax:

1013406024 — AMANDA BAKER PHARMD
Practice Location Address:

2946 S CHURCH ST
MURFREESBORO, TN
37127-8351

Practice Phone: 615-217-2825
Practice Fax:

1144159500 — JORDAN ORDUS
Practice Location Address:

635 LYONS FARM PKWY APT F6202
MURFREESBORO, TN
37127-5864

Practice Phone: 903-380-9812
Practice Fax:

1972432805 — BREANNA ASHLEY STEWARD-FASON
Practice Location Address:

4420 MARCUS VENTURE PL
MURFREESBORO, TN
37127-2302

Practice Phone: 615-669-0511
Practice Fax:

1518951656 — MR. KURT MICHAEL KNOLL PA-C
Practice Location Address:

2910 SOUTH CHURCH STREET, SUITE B
MURFREESBORO, TN
37127-7149

Practice Phone: 615-895-3600
Practice Fax: 615-895-0024

1003890609 — DR. TRAVIS M. JOHNSON O.D.
Practice Location Address:

140 JOE B JACKSON PKWY
MURFREESBORO, TN
37127-7228

Practice Phone: 615-203-9165
Practice Fax:

Directions to “COMMUNITY CARE OF RUTHERFORD COUNTY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.