ELLISVILLE STATE SCHOOL (NPI# 1720181191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720181191 |
| Entity Type | Organization |
| Organization Name | ELLISVILLE STATE SCHOOL |
| Other Organization Name | CLOVER CIRCLE ICF/MR |
| 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 | 2006-09-07 |
| Last Update Date | 2008-06-12 |
| Authorized Official Name | MRS. PAM K YOUNG (ACCOUNTING AUDITOR 1) |
| Authorized Official Telephone | 6014775606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | 233 | MS | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00021831 | 05 |
| Other Name | Type Code |
|---|---|
| Clover Circle ICF/MR | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568468080 | Ellisville State School | Clinic/Center | 1101 Hwy 11 S, Ellisville, MS 39437-4444 | 2005-06-21 |
| 1285947408 | Ellisville State School | Intermediate Care Facility, Mentally Retarded | 1101 Hwy 11 S, Ellisville, MS 39437-4443 | 2010-07-16 |
| 1811135718 | Ellisville State School | Intermediate Care Facility, Mentally Retarded | 1101 Hwy 11 S, Ellisville, MS 39437-4443 | 2009-01-30 |
| 1164582821 | Ellisville State School | Technician | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-11 |
| 1578668901 | Ellisville State School | Pharmacy | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-09-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ELLISVILLE STATE SCHOOL | 1101 Highway 11 S Eville, Ellisville, MS 39437-4443 |
| 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 |
| 1306914700 | Hillside | Nursing Facility/Intermediate Care Facility | 1101 Highway 11 S, Ellisville, MS 39437-4443 | 2006-12-01 |
| 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 |
| 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 | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "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. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932643095 | Diligent Healthcare, LLC | Health Maintenance Organization | 902 Sunset Cir, Columbia, MS 39429-2212 | 2016-12-08 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1538556311 | Rehabilitation Centers, Inc., D/b/a Millcreek of Pontotoc | Health Maintenance Organization | 1814 Highway 15 N, Pontotoc, MS 38863-6962 | 2015-04-20 |
| 1144618471 | Life Senior Home Care LLC | Health Maintenance Organization | 126 Richmond Dr, Brandon, MS 39042-2832 | 2015-01-09 |
| 1154726107 | Golden Years Adult Health Services | Health Maintenance Organization | 121 Colonial Gln, Jackson, MS 39211-3305 | 2014-11-01 |
| 1053730135 | Caring & Loving Hearts LLC | Health Maintenance Organization | 17399 10th St, Gulfport, MS 39503-7922 | 2014-04-15 |
| 1750713004 | Rose Vocational Educational & Transitional Services | Health Maintenance Organization | 430 Briarwood Drive, Suite 400, Jackson, MS 39206 | 2013-08-08 |
| 1700127552 | Helping Hands | Health Maintenance Organization | 9900 Highway 15 S Ste B, 9900 Hwy 15 South Suite B, Ripley, MS 38663-2932 | 2013-03-04 |
| 1609131804 | Broadmoor Adult Enrichment Daycare, Inc. | Health Maintenance Organization | 5176 Keele St, Jackson, MS 39206-4313 | 2012-07-12 |
| 1780972026 | Odyssey Adult Day Services | Health Maintenance Organization | 1304 Clay St, Vicksburg, MS 39183-3012 | 2011-07-20 |
| Find all providers with the same taxonomy | ||||
| City | ELLISVILLE |
| Zip Code | 39437 |
Please comment or provide details below to improve the information on ELLISVILLE STATE SCHOOL.
| 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.