WISTERIA GARDENS, LLC (NPI# 1306031372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306031372 |
| Entity Type | Organization |
| Organization Name | WISTERIA GARDENS, LLC |
| Practice Address |
5420 Highway 80 E Pearl MS 39208-8924 |
| Practice Telephone | 6019886800 |
| Mailing Telephone | 6019886800 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |
| Authorized Official Name | WILLIAM D HILL JR. (ADMINISTRATOR) |
| Authorized Official Telephone | 6019886800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | WISTERIA GARDENS, LLC | 56 Briar Ridge Rd., Ridgefield, CT 06877 |
| Street Address |
5420 HIGHWAY 80 E |
| City | PEARL |
| State | MS |
| Zip Code | 39208-8924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299875 | Catherine Leigh Wilson | Nurse Practitioner | 3794 Ms-468, Pearl, MS 39208 | 2020-09-15 |
| 1548896301 | Rochelle Vanity Cork | Nurse Practitioner | 4635 Us-80, Pearl, MS 39208 | 2020-03-12 |
| 1528600343 | Kelsey D Nowell | Physical Therapy Assistant | 3823 Highway 80 East Suite 1100, Pearl, MS 39208 | 2019-10-14 |
| 1740742329 | Jacksonbracey Health Care | Nurse Practitioner | 4490 Us-80, Pearl, MS 39208 | 2019-04-03 |
| 1740637586 | Telehealthone, LLC | Nurse Practitioner | 5760 Hwy 80 East, Pearl, MS 39208 | 2016-05-23 |
| 1003273897 | Xcel Rehab, Inc. | Clinic/Center | 209 Riverwind East, Suite B, Pearl, MS 39208 | 2016-01-25 |
| 1487035044 | Christopher Rogers | Physical Therapy Assistant | 209 B Riverwind East, Pearl, MS 39208 | 2015-06-09 |
| 1417366725 | Pearl River Dental, Pllc | Dentist | 209 Riverwind East Dr, Pearl, MS 39208 | 2014-08-12 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1437589801 | Leo Easley II | Nurse Practitioner | 3794 Hwy 468, Pearl, MS 39208 | 2013-11-20 |
| Find all providers in zip 39208 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1982811642 | State Veterans Affairs Board | Skilled Nursing Facility | 3466 Highway 80 E, Pearl, MS 39208-4001 | 2007-05-16 |
| 1467532903 | Mississippi State Hospital | Skilled Nursing Facility | 3550 Highway 468 W, Pearl, MS 39208-5529 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1053834747 | St. Catherine's Village, Inc | Skilled Nursing Facility | 200 Dominican Dr, Madison, MS 39110-8630 | 2017-07-25 |
| 1851839435 | Parker Medical Services, LLC | Skilled Nursing Facility | 1060 Lisa Ln, Terry, MS 39170-8092 | 2017-02-03 |
| 1114386687 | Genesis Healthcare | Skilled Nursing Facility | 2142 E Whitworth St, Hazlehurst, MS 39083-9277 | 2016-02-12 |
| 1003274150 | Vincent Huffstutler | Skilled Nursing Facility | 201 Mary Ellen Dr, Ripley, MS 38663-1658 | 2016-02-04 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1679819890 | Global Home Care, LLC | Skilled Nursing Facility | 4213 Pruitt Rd, West Point, MS 39773-4517 | 2012-12-14 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1700132065 | The Arbor | Skilled Nursing Facility | 600 S Pear Orchard Rd, Ridgeland, MS 39157-4221 | 2012-07-24 |
| 1952673162 | Ltc Solutions | Skilled Nursing Facility | 277 Cuba St, Holly Springs, MS 38635-2102 | 2012-02-02 |
| 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.