Community Care Center of Aberdeen
Organization Active NPI Skilled Nursing Facility · Aberdeen, MS
NPI 1063628451 · NPPES record last updated Apr 29, 2013
Key facts
- NPI
- 1063628451
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 561 (MS)
- Legal business name
- COMMUNITY CARE CENTER OF ABERDEEN
- Practice address
- 505 Jackson St
Aberdeen, MS 39730-3349 - Phone
- (662) 369-6431
- Fax
- (662) 369-6473
- NPI assigned
- May 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. David W Stallard
- Title
- Provider Representative
- Phone
- (601) 956-8884
Owners & managing parties with NPI records 1
-
Kevin Curtis Hayes, M.D.
Facilities with the same owner 51
Practitioners 2
-
Kevin Curtis Hayes, M.D.
Affiliated clinicians 2
-
Kevin Curtis Hayes, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Care Center of Aberdeen
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 1, 1987
- Medicare certification status
- Active
- Certified beds
- 105 · 90.2 residents per day on average
- Penalties (3 years)
- 1 · fines totaling $10,358
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Skilled nursing facility certification: CCN 255097
- Legal name
- COMMUNITY CARE CENTER OF ABERDEEN
- Doing business as
- CARE CENTER OF ABERDEEN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1987
- Last certification
- May 15, 2025
- Beds
- 105
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 505 Jackson St
Aberdeen, MS 39730-3349 - Nursing home name
- CARE CENTER OF ABERDEEN
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Allison Knight Carter |
Operational/Managerial Control | Feb 10, 2020 | |
| Adp of the SNF | Feb 10, 2010 | ||
| Account Management Services Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Regional Care LLC |
Operational/Managerial Control | Jan 1, 2014 | |
| Four Generations Holdings LLC |
Adp of the SNF | Jan 23, 2026 | |
| Kari M Beasley |
Operational/Managerial Control | Apr 7, 2020 | |
| Regional Services, Inc |
Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Toni H Parkinson |
Corporate Officer |
Nov 15, 2015 | |
| Provider Professional Services Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Nutrition Systems Consulting Inc |
Adp of the SNF | Feb 28, 2010 | |
| Carol Sweeney |
Operational/Managerial Control | Jun 11, 2019 | |
| Administrative Systems Inc |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Bobby L Beebe |
Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Tristar Rehab Inc |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Jefferson Boyd and Jojuana Summit TR |
5% Or Greater Direct Ownership Interest | Jan 1, 2010 | 100% |
| Operational/Managerial Control | Jan 1, 2010 | ||
| Adp of the SNF | Jan 20, 2026 | ||
| David a Flippin |
Operational/Managerial Control |
Jan 1, 2014 | |
| Kevin Curtis Hayes |
Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Jan 1, 2010 | ||
| Elton G Beebe Family Mortage Trust |
Adp of the SNF | Jan 23, 2026 | |
| Pharmaceutical Consulting Services of America LLC |
Adp of the SNF | Oct 31, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100215000830 | MS | Part a Provider - Skilled Nursing Facility | 5597809566 | Practice locations: Aberdeen, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 561 | MS | Yes |
Addresses
Primary practice location
505 Jackson St
Aberdeen, MS 39730-3349
Mailing address
505 Jackson St
Aberdeen, MS 39730-3349
Phone (662) 369-6431
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00230034 | Medicaid | MS |
Other names
- Care Center of Aberdeen
Other providers in Aberdeen, MS
- Lindsey R Chandler
- Cheyenne'S Total Care/Transporation
- Child & Family Services, LLC
- Clay County Medical Corporation
- Holly Elizabeth Colbert
- Thelma Cox-Shelton
- Creative Healing Counseling Services, LLC
- Eunice Crump
- Lateisha Shavonte Cunningham
- Curries Family Care Pharmacy of Aberdeen,Inc
All providers in Aberdeen, MS · Skilled Nursing Facility in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.