VICKSBURG CONVALESCENT, LLC (NPI# 1578553459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578553459 |
| Entity Type | Organization |
| Organization Name | VICKSBURG CONVALESCENT, LLC |
| Other Organization Name | VICKSBURG CONVALESCENT CENTER |
| Practice Address |
1708 Cherry St Vicksburg MS 39180 |
| Mailing Address |
9020 Overlook Blvd Ste 202 Brentwood TN 37027-2755 |
| Practice Telephone | 6016383632 |
| Practice Fax Number | 6016383998 |
| Mailing Telephone | 6152507100 |
| Mailing Fax Number | 6152507102 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | MR. WILLIAM D. ORAND (CEO) |
| Authorized Official Telephone | 6152507100 |
| Is Organization Subpart | Y |
| Parent Organization Name | VANGUARD HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 176 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00220334 | 05 |
| Other Name | Type Code |
|---|---|
| Vicksburg Convalescent Center | Doing Business As Name - Organization |
| Street Address |
1708 CHERRY ST |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| 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 |
|---|---|---|---|---|
| 1548210289 | Covenant Health & Rehab of Vicksburg, Lp | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2006-05-11 |
| 1225086374 | Community Care Center of Vicksburg LLC | Skilled Nursing Facility | 3103 Wisconsin Ave, Vicksburg, MS 39180-4825 | 2006-05-04 |
| 1184613143 | Shady Lawn, LLC | Skilled Nursing Facility | 60 Shady Lawn Pl, Vicksburg, MS 39180 | 2005-10-20 |
| 1215420278 | Nexion Health At Vicksburg, Inc. | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2018-06-13 |
| 1972001493 | Porters Chapel Opco, LLC | Skilled Nursing Facility | 60 Shady Lawn Pl, Vicksburg, MS 39180 | 2018-01-30 |
| 1902093396 | The Bluffs Rehabilitation and Healthcare Center, LLC | Skilled Nursing Facility | 2850 Porters Chapel Rd, Vicksburg, MS 39180-1805 | 2007-09-28 |
| 1568400604 | Vicksburg Healthcare LLC | Skilled Nursing Facility | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-02 |
| 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 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 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 |
| 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.