Covenant Cove Care LLC

Primary specialty

DriverTaxonomy code 172A00000X

Legal business name

COVENANT COVE CARE LLC

Practice address

101 Kirk Ave Apt C7
Grenada, MS 38901-2880

Phone

(662) 647-7546

NPI assigned

Nov 9, 2023

Organization subpart

No

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

Authorized official

Name

Georgeanna StokesNPI 1033983184

Title

Owner

Phone

(662) 647-7546

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Covenant cove care LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Georgeanna Stokes

  • Driver
  • Grenada, MS
  • NPI 1033983184
  NPD Authorized official

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1104690197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KIRK AVE APT C7",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389012880",
            "telephone_number": "662-647-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 KIRK AVE APT C7",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389012880",
            "telephone_number": "662-647-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT COVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "GEORGEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-647-7546"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033983184",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant cove care LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covenant cove care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• CMHP Enterprises
• John Henry Coleman, D.M.D.
• Andrea Jemae Collins, M.D.
• Community Care Center of Grenada, LLC
• Anna Cooper
• Laurie Lynn Crain, MASTERS OF SCIENCE
• Wallace Edgar Cresswell, P.T.
• Betsy Cummings, CFNP
• Robyn Richardson Dalton
• Darley J Solomon Jr MD PC

• All providers in Grenada, MS
• Driver in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.