MID-DELTA HOME HEALTH OF CHARLESTON, INC. (NPI# 1457376360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457376360 |
| Entity Type | Organization |
| Organization Name | MID-DELTA HOME HEALTH OF CHARLESTON, INC. |
| Practice Address |
617 N State St Clarksdale MS 38614-6517 |
| Mailing Address |
Po Box 373 Belzoni MS 39038-0373 |
| Practice Telephone | 6626244910 |
| Practice Fax Number | 6622474924 |
| Mailing Telephone | 6622471254 |
| Mailing Fax Number | 6622474924 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-05-08 |
| Authorized Official Name | MRS. CLARA T. REED (CEO) |
| Authorized Official Telephone | 6622471254 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 7588 | MS | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 121587 | 05 | |
| MS | 770387 | 05 | |
| MS | BLUE CROSS | 70645 | 01 |
| MS | 70507 | 05 | |
| MS | 770448 | 05 | |
| MS | DME | 640718392A | 01 |
| Street Address |
617 N STATE ST |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-6517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184687725 | Mid-delta Hospice North Inc | Hospice Care, Community Based | 617 N State St, Clarksdale, MS 38614-6517 | 2006-04-06 |
| 1700178662 | Jayshree J Patel | Physical Therapy Assistant | 617 N State St, Clarksdale, MS 38614-6517 | 2011-05-11 |
| 1629360581 | Africa Joanalene Harris | Physical Therapist | 617 N State St, Clarksdale, MS 38614-6517 | 2011-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700304151 | Kimberly Michelle Dye | Home Health | 1015 Sasse St, Clarksdale, MS 38614-7533 | 2017-09-06 |
| 1326325531 | Healing Hands Home Health | Home Health | 1742 N State St, Clarksdale, MS 38614-6620 | 2011-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122733 | Blessing Hearts Private Duty Home Care LLC | Home Health | 105 N Cherry St, Tylertown, MS 39667-2308 | 2020-10-23 |
| 1568061406 | True Alliance Home Healthcare, LLC | Home Health | 6950 Dakota Cir S, Olive Branch, MS 38654-9064 | 2020-10-21 |
| 1043818925 | Home In The Heart Health Care Agency, LLC | Home Health | 5915 Brice Cv N, Olive Branch, MS 38654-3529 | 2020-10-13 |
| 1689271017 | Thompson Healthcare Services, LLC | Home Health | 208 Grace Dr, Flowood, MS 39232-5511 | 2020-10-08 |
| 1760089346 | Natasha Turner | Home Health | 224 Cedar St, Kosciusko, MS 39090-4504 | 2020-10-06 |
| 1164029930 | Just Like Family Home Care LLC | Home Health | 910 E Northside Dr # 910e, Jackson, MS 39206-5533 | 2020-10-05 |
| 1235743162 | Shymeka Bolden | Home Health | 405 Dewitt Ave, Jackson, MS 39203 | 2020-09-08 |
| 1023620887 | Porsche Ann Walley | Home Health | 5101 Orchard Ave Apt 91, Pascagoula, MS 39581-3907 | 2020-08-21 |
| 1750993358 | Tab, LLC | Home Health | 785 Creston Dr, Byram, MS 39272-3001 | 2020-08-17 |
| 1740891506 | Trucare Sitters LLC | Home Health | 908 Bickerstaff St, Tupelo, MS 38801-6802 | 2020-08-13 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
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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.