Wilkinson County Senior Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

379 Issued in MS

Legal business name

WILKINSON COUNTY SENIOR CARE LLC

Practice address

166 S Lafayette St
Centreville, MS 39631-3571

Phone

(601) 645-5253

Fax

(601) 645-6389

NPI assigned

Aug 10, 2007

Last updated

Aug 10, 2007By 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

Mrs. Tina Ellis

Title

Comptroller

Phone

(601) 304-0980

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053503318. Details of each certification follow.

• CCN 255126 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 255126

Legal name

WILKINSON COUNTY SENIOR CARE LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 1, 1989

Last certification

Mar 28, 2024

Beds

60

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Trend LTC

Organization structure

LLCProprietary

Incorporated

Aug 1, 2007 in MS

Enrollment address

166 South Lafayette Street
Centreville, MS 39631-3571

Nursing home name

WILKINSON COUNTY SENIOR CARE

Affiliated entity

TREND CONSULTANTS

Listed as

Wilkinson County Senior CareCCN 255126 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jun 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6053.7 residents per day on average

Chain

Trend Consultants15 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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.

• Robert L Lewis, MD

  • Internal Medicine Physician
  • Woodville, MS
  • NPI 1093752115
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Robert L Lewis, MD

  • Internal Medicine Physician
  • Woodville, MS
  • NPI 1093752115

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1053503318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 S LAFAYETTE STREET",
            "address_2": "P O BOX 310",
            "city": "CENTREVILLE",
            "state": "MS",
            "postal_code": "396310310",
            "telephone_number": "601-645-5253",
            "fax_number": "601-645-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 S LAFAYETTE ST",
            "city": "CENTREVILLE",
            "state": "MS",
            "postal_code": "396313571",
            "telephone_number": "601-645-5253",
            "fax_number": "601-645-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKINSON COUNTY SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "601-304-0980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Benoit Schott, LCSW
• SE Mississippi Emergency Physicians LLC
• Thomas Lobrano DDS PA
• Shelby T White, MD
• Wilkinson County Nursing Center LLC

• Skilled Nursing Facility in Centreville, MS
• Providers in Centreville, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.