NORTH STREET HEALTHCARE LLC (NPI# 1568791804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568791804 |
Entity Type | Organization |
Organization Name | NORTH STREET HEALTHCARE LLC |
Other Organization Name | COMPERES NURSING HOME |
Practice Address |
865 North St Jackson MS 39202-3020 |
Mailing Address |
323 Highland Blvd Natchez MS 39120-4635 |
Practice Telephone | 6019486531 |
Practice Fax Number | 6019486166 |
Mailing Telephone | 6013040980 |
Mailing Fax Number | 6013041155 |
Enumeration Date | 2009-12-16 |
Last Update Date | 2009-12-16 |
Authorized Official Name | MR. CHARLES BRUCE KELLY (MANAGING MEMBER) |
Authorized Official Telephone | 6013040980 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | APPLING FOR | MS | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00230016 | 05 |
Other Name | Type Code |
---|---|
Comperes Nursing Home | Doing Business As Name - Organization |
Street Address |
865 NORTH ST |
City | JACKSON |
State | MS |
Zip Code | 39202-3020 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
Find all providers in zip 39202 |
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 |
---|---|---|---|---|
1326348897 | Laurie L. Mcbride | Skilled Nursing Facility | 180 W University Pkwy Ste H, Jackson, TN 38305-1612 | 2010-10-29 |
1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
1679712665 | West Tennessee Transitional Care Inc | Skilled Nursing Facility | 597 West Forest Ave, Jackson, TN 38301 | 2009-02-13 |
1285802652 | Trilogy Healthcare of Jackson, LLC | Skilled Nursing Facility | 703 Robinson Road, Jackson, MI 49203-2538 | 2008-02-19 |
1174732333 | Louisiana War Veterans Home | Skilled Nursing Facility | 4739 Highway 10, Jackson, LA 70748 | 2007-05-22 |
1760521256 | Omni Visions, Inc | Skilled Nursing Facility | 50 Directors Row, Jackson, TN 38305 | 2007-02-05 |
1326197211 | Cottage Grove Nursing Home, Lp | Skilled Nursing Facility | 1116 Forest Ave, Jackson, MS 39206-3216 | 2007-01-09 |
1164597688 | Countryside Care Center, Inc. | Skilled Nursing Facility | 2121 Robinson Rd, Jackson, MI 49203-3658 | 2006-11-21 |
1073687083 | Chadwick Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1900 Chadwick Dr, Jackson, MS 39204-3406 | 2006-11-20 |
1083788053 | Lakeland Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 3680 Lakeland Ln, Jackson, MS 39216-4707 | 2006-11-20 |
Find all providers in JACKSON |
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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.