Angel Wings Community Healthcare Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ANGEL WINGS COMMUNITY HEALTHCARE CENTER LLC

Practice address

215 Magnolia St
Magnolia, MS 39652-2827

Phone

(601) 869-0299

Fax

(601) 680-3216

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Latoya Cameron, FNPNPI 1619530425

Title

Owner

Phone

(601) 869-0299

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latoya R Cameron, CFNP

  • Family Nurse Practitioner
  • McComb, MS
  • NPI 1619530425
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1053099077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MAGNOLIA ST",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "396522827",
            "telephone_number": "601-869-0299",
            "fax_number": "601-680-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MAGNOLIA ST",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "396522827",
            "telephone_number": "601-869-0299",
            "fax_number": "601-680-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL WINGS COMMUNITY HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-869-0299",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia B Adams
• Angel Wings Transit Inc
• Angel Wings, LLC
• Angel Wings, LLC Group Home & Personal and Respite Care Services
• Kirsten Leanna Ashley, PTA
• Sokhen Bates

• Family Medicine Physician in Magnolia, MS
• Providers in Magnolia, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.