LEAKE LTC, LLC (NPI# 1245684612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245684612 |
| Entity Type | Organization |
| Organization Name | LEAKE LTC, LLC |
| Other Organization Name | CARTHAGE HEALTH & REHAB CENTER |
| Practice Address |
310 Ellis St Carthage MS 39051-3809 |
| Practice Telephone | 6012671432 |
| Practice Fax Number | 6012671211 |
| Mailing Telephone | 6012671432 |
| Mailing Fax Number | 6012671211 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |
| Authorized Official Name | BRIEN B HUBBARD (MANAGER) |
| Authorized Official Telephone | 6018492294 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Carthage Health & Rehab Center | Doing Business As Name - Organization |
| Street Address |
310 ELLIS ST |
| City | CARTHAGE |
| State | MS |
| Zip Code | 39051-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831174804 | Leake County Board of Trustees | General Acute Care Hospital | 310 Ellis St, Carthage, MS 39051-3809 | 2005-12-13 |
| 1720336126 | Baptist Medical Center -leake Inc | Hospitalist | 310 Ellis St, Carthage, MS 39051-3809 | 2012-08-16 |
| 1588940811 | Baptist-leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2011-11-01 |
| 1891832747 | William D Logan Jr. | Emergency Medicine | 310 Ellis St, Carthage, MS 39051-3809 | 2007-01-31 |
| 1750456034 | Leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2006-11-21 |
| 1023187689 | Tommie K Jones | Nurse Practitioner | 310 Ellis St, Carthage, MS 39051-3809 | 2006-11-07 |
| 1073545554 | Evan J. Pickus | Emergency Medicine | 310 Ellis St, Carthage, MS 39051-3809 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598275828 | Roots Healthcare and Homes, LLC | Meals | 292 Pickens Circle, Carthage, MS 39051 | 2017-09-30 |
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1750738415 | Telehealthone LLC | Nurse Practitioner | 300 South Pearl Street, Carthage, MS 39051 | 2016-05-23 |
| 1316297575 | Silver Lining Adult Daycare, LLC | Respite Care | 531 Highway 35 North, Carthage, MS 39051 | 2012-09-14 |
| 1508179888 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 205 Highway 16 West, Carthage, MS 39051 | 2010-07-15 |
| 1376725754 | Amye L Shamburger | Dentist | 101 S. Pearl Street, Carthage, MS 39051 | 2007-11-28 |
| 1770786188 | Carthage Eye Clinic Pa | Optometrist | 201 Hwy 16 East, Carthage, MS 39051 | 2007-06-06 |
| 1265553762 | David C Henderson | Dentist | 113 North Pearl St, Carthage, MS 39051 | 2007-04-02 |
| 1780722280 | Linda N Roland | Nurse Practitioner | 204 Chipley St., Carthage, MS 39051 | 2007-02-05 |
| 1205914298 | William M Myers II | Dentist | 12646 Hwy 488, Carthage, MS 39051 | 2006-11-01 |
| Find all providers in zip 39051 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477934339 | Hancock County Senior Services Association | Nursing Facility/Intermediate Care Facility | 401 S Adams St, Carthage, IL 62321-1652 | 2015-06-16 |
| 1588940811 | Baptist-leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2011-11-01 |
| 1750456034 | Leake Extended Care Facility | Nursing Facility/Intermediate Care Facility | 310 Ellis St, Carthage, MS 39051-3809 | 2006-11-21 |
| 1518917756 | Hancock County Nursing Home | Nursing Facility/Intermediate Care Facility | 402 S Adams St, Carthage, IL 62321-1600 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467842641 | Crossroads Adult Day Care | Nursing Facility/Intermediate Care Facility | 519 S Church St, Brookhaven, MS 39601-3807 | 2015-01-27 |
| 1699108860 | Holistic Geriatric Care LLC | Nursing Facility/Intermediate Care Facility | 10026 Lizelia Rd, Meridian, MS 39305-9595 | 2013-08-12 |
| 1538492111 | Iva Ward LLC | Nursing Facility/Intermediate Care Facility | 711 Melrose Montebello Pkwy, Natchez, MS 39120-4924 | 2009-09-14 |
| 1295961969 | River Oaks Management, LLC | Nursing Facility/Intermediate Care Facility | 501 Highway 80 E, Brandon, MS 39042-3257 | 2009-06-08 |
| 1063697340 | North Bolivar School District | Nursing Facility/Intermediate Care Facility | 615 School Street, Duncan, MS 38740 | 2008-01-04 |
| 1659555761 | Tallahatchie General Hospital and Extended Care Facility | Nursing Facility/Intermediate Care Facility | 201 South Market Street, Charleston, MS 38921 | 2007-12-26 |
| 1568683498 | Whitfield Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 2101 Proper St, Corinth, MS 38834-5247 | 2007-05-01 |
| 1265656391 | Gilberto Patino | Nursing Facility/Intermediate Care Facility | 419 Elizabeth Drive, Leakesville, MS 39451 | 2007-04-12 |
| 1013048453 | Bruce Nursing Center, Inc. | Nursing Facility/Intermediate Care Facility | 176 Hwy 9 South, Bruce, MS 38915 | 2007-03-08 |
| 1326178203 | Smith County Ltc, LLC | Nursing Facility/Intermediate Care Facility | 309 Magnolia Drive, Raleigh, MS 39153 | 2007-03-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.