MID SOUTH SENIOR CARE, LLC (NPI# 1417353103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417353103 |
| Entity Type | Organization |
| Organization Name | MID SOUTH SENIOR CARE, LLC |
| Other Organization Name | MID-SOUTH SENIOR CARE |
| Practice Address |
5050 Poplar Ave Suite 2400 Memphis TN 38157-0101 |
| Practice Telephone | 9017667660 |
| Practice Fax Number | 9013281353 |
| Mailing Telephone | 9017667660 |
| Mailing Fax Number | 9013281353 |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2014-11-07 |
| Authorized Official Name | MR. MICHAEL CHAD GILLILAND (PRESIDENT) |
| Authorized Official Telephone | 9017667660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | L000000013736 | TN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | H445514 | 05 |
| Other Name | Type Code |
|---|---|
| Mid-South Senior Care | Doing Business As Name - Organization |
| Street Address |
5050 POPLAR AVE SUITE 2400 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38157-0101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336145317 | Garrettson S Ellis | Internal Medicine | 5050 Poplar Ave, Suite 800, Memphis, TN 38157-0101 | 2005-06-23 |
| 1952832867 | Tiffany Wright | Nurse Practitioner | 5050 Poplar Ave, Suite 800, Memphis, TN 38157-0101 | 2017-03-22 |
| 1922557909 | Mahmod Abdelghani | Nurse Practitioner | 5050 Poplar Ave, Suite 800, Memphis, TN 38157-0101 | 2016-10-01 |
| 1316317407 | Rha Health Services Tn, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5050 Poplar Ave, Suite 710, Memphis, TN 38157-0101 | 2015-10-01 |
| 1801292081 | Mid-south Home Health, LLC | Chore Provider | 5050 Poplar Ave, Suite #2404, Memphis, TN 38157-0101 | 2014-11-14 |
| 1174925143 | Memphis Men's Clinic, PC | Specialist/Technologist, Other | 5050 Poplar Ave, Ste 718, Memphis, TN 38157-0101 | 2014-09-22 |
| 1427308618 | Alida Novarese Gage | Psychologist | 5050 Poplar Ave, Ste 1632, Memphis, TN 38157-1632 | 2012-09-14 |
| 1033465620 | Methodist Le Bonheur Healthcare Eap | Counselor | 5050 Poplar Ave, Suite # 1118, Memphis, TN 38157-0101 | 2012-08-01 |
| 1023376878 | David Irvin Williams | Internal Medicine | 5050 Poplar Ave, Ste 800, Memphis, TN 38157-0800 | 2012-04-30 |
| 1396938239 | John J Harris Md PC | Psychiatry & Neurology | 5050 Poplar Ave, Suite 618, Memphis, TN 38157-0618 | 2007-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285869503 | Nathan Eric Wilds | Internal Medicine | 5050 Poplar Ave., Suite 800, Mid-south Pulmonary Specialists, P.C., Memphis, TN 38157 | 2009-05-17 |
| 1669018859 | Angela Carroll Childs | Specialist/Technologist, Other | 5050 Poplar Ave Ste 300, Memphis, TN 38157-0300 | 2019-11-21 |
| 1407813439 | Mark S Ledoux | Psychiatry & Neurology | 5050 Poplar Ave Ste 511, Memphis, TN 38157-0500 | 2006-04-26 |
| 1912565946 | Veracity Neuroscience LLC | Psychiatry & Neurology | 5050 Poplar Ave Ste 511, Memphis, TN 38157-0500 | 2019-06-04 |
| 1720503659 | Cura Partners, LLC | In Home Supportive Care | 5050 Poplar Ave Ste 535, Memphis, TN 38157-0535 | 2017-08-11 |
| 1407115579 | Allyson Brooke Williams | Nurse Practitioner | 5050 Poplar Avenue Suite 511, Memphis, TN 38157-0618 | 2012-05-10 |
| 1952667503 | Kimberly Anne Marsh | Internal Medicine | Mid-south Pulmonary Specialists, P.C., 5050 Poplar Ave., Suite 800, Memphis, TN 38157-0800 | 2012-04-09 |
| 1710019930 | Michael Munday | Internal Medicine | 5050 Poplar Ave Ste 800, Memphis, TN 38157-0800 | 2007-03-12 |
| 1972014942 | Nicholas L Pickett | Nurse Practitioner | 5050 Poplar Ave Ste 800, Memphis, TN 38157-0800 | 2017-10-18 |
| 1205353224 | Ashley Williford | Nurse Practitioner | 5050 Poplar Ave Ste 800, Memphis, TN 38157-0800 | 2017-08-30 |
| Find all providers in zip 38157 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606706 | Trinette Jackson | In Home Supportive Care | 905 Woodlawn St, Memphis, TN 38107-2531 | 2020-10-13 |
| 1871103564 | Kv Quality Care | In Home Supportive Care | 109 Lynnfield St, Memphis, TN 38120-2305 | 2020-08-06 |
| 1801406749 | Home Care Management Nursing Agency LLC | In Home Supportive Care | 602 Harrell St, Memphis, TN 38112-2932 | 2020-08-05 |
| 1013526425 | Peeples Choice | In Home Supportive Care | 5263 Cherokee Rose Ln, Memphis, TN 38125-4119 | 2020-07-31 |
| 1427667641 | Alecia Alexander | In Home Supportive Care | 696 Inez St, Memphis, TN 38111-2223 | 2020-07-23 |
| 1548884281 | Peaceful Transitions In-home Care Services Inc | In Home Supportive Care | 4384 Stage Rd Ste 204, Memphis, TN 38128-5762 | 2020-05-28 |
| 1386265296 | Heart To Home Healthcare Services Inc | In Home Supportive Care | 3385 Airways Boulevard, Suite 233, Memphis, TN 38116 | 2020-05-01 |
| 1811516826 | Comforts of Life Home Care Inc | In Home Supportive Care | 4523 Millbranch Rd, Memphis, TN 38116-7437 | 2020-04-09 |
| 1548896715 | Annie M Griffin | In Home Supportive Care | 1014 Cullenwood Drive, Memphis, TN 38116 | 2020-03-19 |
| 1417583014 | The Connection Center | In Home Supportive Care | 1317 Jackson Ave, Memphis, TN 38107-4334 | 2020-03-16 |
| Find all providers in MEMPHIS | ||||
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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.