Active NPI
Mikey'S Memory HCBS LLC
- Home Health Agency
- Long Beach, MS
National Provider Identifier
1104702687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- MIKEY'S MEMORY HCBS LLC
- Practice address
- 18308 Commission Rd Ste a
Long Beach, MS 39560-2402 - Phone
- (228) 343-6734
- NPI assigned
- Aug 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William Dodson, CNA, CCMA
- Title
- Founder/Ceo
- Phone
- (228) 255-5755
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary | ||
| Community Based Hospice Care Agency | 251G00000X | |||
| Adult Day Care Clinic/Center | 261QA0600X | |||
| Developmental Disabilities Clinic/Center | 261QD1600X | |||
| Nurse's Aide | 376K00000X | |||
| Respite Care | 385H00000X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X |
Addresses
Primary practice location
18308 Commission Rd Ste a
Long Beach, MS 39560-2402
Mailing address
18308 Commission Rd Ste a
Long Beach, MS 39560-2402
Phone (228) 255-5755
Other names 1
- William Dodson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wmdodson@mikeysmemoryhcbs.com | Health Information Exchange (HIE) |
National Provider Directory
National Provider Directory- Tax ID family
- Mikey'S Memory HCBS LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Long Beach, MS
- NPI 1942175013
Locations
18308A Commission Rd
Ste A
Long Beach, MS 39560
Phone (228) 343-6734
18308 Commission Rd
Ste A
Long Beach, MS 39560
Phone (228) 255-5755
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Home Health Agency
- Long Beach, MS
- NPI 1659086486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759968000000",
"number": "1104702687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18308 COMMISSION RD STE A",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395602402",
"telephone_number": "228-255-5755",
"fax_number": "228-678-2348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18308 COMMISSION RD STE A",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395602402",
"telephone_number": "228-343-6734"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIKEY'S MEMORY HCBS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-12",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A",
"authorized_official_last_name": "DODSON",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "FOUNDER/CEO",
"authorized_official_telephone_number": "228-255-5755",
"authorized_official_credential": "CNA, CCMA"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "wmdodson@mikeysmemoryhcbs.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "any",
"address_1": "18308 Commission Rd Ste A",
"city": "Long Beach",
"state": "MS",
"country_code": "US",
"postal_code": "395602402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "William Dodson",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Long Beach, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.