HILLSIDE (NPI# 1306914700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306914700 |
| Entity Type | Organization |
| Organization Name | HILLSIDE |
| Practice Address |
1101 Highway 11 S Ellisville MS 39437-4443 |
| Practice Telephone | 6014779384 |
| Practice Fax Number | 6014775700 |
| Mailing Telephone | 6014779384 |
| Mailing Fax Number | 6014775700 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SUZIE LASSITER (DIRECTOR OF FACILITY) |
| Authorized Official Telephone | 6014779384 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 586 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00021780 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972620763 | Hillside | Assisted Living Facility | 300 Nw Hillside Pkwy, Mcminnville, OR 97128-9567 | 2007-03-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HILLSIDE | 611 N Main St, Newberg, OR 97132 |
| New York State Corporations | HILLSIDE "28" LLC | P.o. Box 228, Wyoming, Ny 14591 |
| New York State Corporations | HILLSIDE # 1 DELI CORP. | 164-01 Hillside Avenue, Jamaica, Ny 11432 |
| Colorado Business Entities | Hillside (Colorado) LLC | Two Greentree Centre, 9000 Lincoln Drive East, Suite 200, Marlton, NJ 08053 |
| New York State Corporations | HILLSIDE (FANTASY) LLC | 28 Liberty St., New York, Ny 10005 |
| Colorado Business Entities | Hillside (Fantasy) LLC | Two Greentree Center, 9000 Lincoln Drive East, Marlton, NJ 08053 |
| Connecticut Business Registrations | HILLSIDE 120 LLC | 34 Connecticut Blvd, East Hartford, CT 06108 |
| New York State Corporations | HILLSIDE 148 LLC | 248-25 Northern Blvd, Suite 210, Little Neck, Ny 11362 |
| New York State Corporations | HILLSIDE 168 INC. | 4630 Kissena Blvd, Flushing, Ny 11355 |
| New York State Corporations | HILLSIDE 175 MEAT CORP. | 175-35 Hillside Avenue, Jamaica, New York 11432 |
| Street Address |
1101 HIGHWAY 11 S |
| City | ELLISVILLE |
| State | MS |
| Zip Code | 39437-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255364337 | Joseph Rodney Moring | Emergency Medicine | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-07-09 |
| 1700125895 | Breanna L Bonner | Nurse Practitioner | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2013-02-08 |
| 1992865653 | Home Community Base Waiver - Ess | Technician | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-11 |
| 1164582821 | Ellisville State School | Technician | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-11 |
| 1205904604 | Pecan Grove | Nursing Facility/Intermediate Care Facility | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 1598833998 | Paul D. Cotten | Nursing Facility/Intermediate Care Facility | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 1013085414 | Ellisville State School Dental | Dentist | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 1508962101 | Lisa Graham Blesse | Nurse Practitioner | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-09-15 |
| 1578668901 | Ellisville State School | Pharmacy | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-09-13 |
| 1720181191 | Ellisville State School | Health Maintenance Organization | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227759 | Courtney J. Sims | Nurse Practitioner | 80 Hal Crocker Road, Ellisville, MS 39437 | 2020-02-19 |
| 1891228581 | Magnolia Gardens Assisted Living | Assisted Living Facility | 303 East Ivy, Ellisville, MS 39437 | 2017-04-10 |
| 1972851814 | Dental Group of Ellisville, Pllc | Dentist | 97 Hal Crocker Road, Ellisville, MS 39437 | 2012-08-27 |
| 1891920518 | Amy E Young | Speech-Language Pathologist | 471 Hwy 590, Ellisville, MS 39437 | 2009-05-26 |
| 1053486852 | Natalia Angelia Stevenson | Nurse Practitioner | Ellisville State School, 1101 Hwy 11 South, Ellisville, MS 39437 | 2006-11-21 |
| 1831275189 | Womens Pavilion of South Mississippi, Pllc | Obstetrics & Gynecology | 1242 Hwy 29 North, Ellisville, MS 39437 | 2006-10-30 |
| 1861578635 | Jennifer Reeder Mascagni | Nurse Practitioner | 1203 Ave B Ste 200, Ellisville, MS 39437 | 2006-10-27 |
| 1851499982 | Kathleen Frances Mccoy | Physical Therapist | 1101 Hwy 11 South, Ellisville, MS 39437 | 2006-09-20 |
| 1861498610 | Patricia A. Tibbs | Pediatrics | 1203 Avenue B, Ellisville, MS 39437 | 2005-06-27 |
| 1700954765 | Shelia Dianne Bradford | Nurse Practitioner | 1203 Avenue B, Ellisville, MS 39437 | 2006-11-30 |
| Find all providers in zip 39437 | ||||
| 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 |
|---|---|---|---|---|
| 1205904604 | Pecan Grove | Nursing Facility/Intermediate Care Facility | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 1598833998 | Paul D. Cotten | Nursing Facility/Intermediate Care Facility | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 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 | ||||
| City | ELLISVILLE |
| Zip Code | 39437 |
Please comment or provide details below to improve the information on HILLSIDE.
| 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.