Active NPI
Lafayette LTC, Inc
Doing business as Oxford Health & Rehab Center
- Skilled Nursing Facility
- Oxford, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 185
- Legal business name
- LAFAYETTE LTC, INC
- Doing business as
- Oxford Health & Rehab Center
- Practice address
- 1301 Belk Blvd
Oxford, MS 38655-5301 - Phone
- (662) 234-7821
- Fax
- (662) 234-0294
- NPI assigned
- Aug 25, 2006
- Last updated
- Jan 15, 2015
- 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
- Mr. Gene Bennett Hubbard Jr.
- Title
- Owner
- Phone
- (601) 849-2294
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 185 | MS | Primary |
Addresses
Primary practice location
1301 Belk Blvd
Oxford, MS 38655-5301
Mailing address
1301 Belk Blvd
Oxford, MS 38655-5301
Phone (662) 234-7821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00230078 | Medicaid | MS |
Other names 1
- Oxford Health & Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040204000727 | MS | Part A Provider - Skilled Nursing Facility | 5092608943 | Practice locations: Oxford, MS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1124135827. Details of each certification follow.
Skilled nursing facility certification: CCN 255269
- Legal name
- LAFAYETTE LTC, INC
- Doing business as
- GRACELAND CARE CENTER OF OXFORD
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 2001
- Last certification
- Sep 5, 2024
- Beds
- 120
- Ownership / control type
- Corporation
- Multi-facility organization
- Advanced Healthcare Management
- Organization structure
- Corporation
- Incorporated
- Sep 3, 2003 in MS
- Enrollment address
- 1301 Belk Blvd
Graceland Care Center of Oxford
Oxford, MS 38655-5301 - Nursing home name
- OXFORD HEALTH & REHAB CENTER
- Affiliated entity
- ADVANCED HEALTH CARE MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Oxford Health & Rehab Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 2001
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Advanced Health Care Management
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0669964 | Oxford Health and Rehab Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Troy Griffin | 5% Or Greater Indirect Ownership Interest | Sep 3, 2003 | 50% |
| Corporate Officer | Sep 3, 2003 | 50% | |
| W-2 Managing Employee | Sep 3, 2003 | 50% | |
| Gene B Hubbard | 5% Or Greater Indirect Ownership Interest | Sep 3, 2003 | 50% |
| Corporate Officer | Sep 3, 2003 | 50% | |
| W-2 Managing Employee | Sep 3, 2003 | 50% | |
| Advanced Healthcare Management, Inc | 5% Or Greater Direct Ownership Interest | Sep 3, 2003 | 100% |
| Operational/Managerial Control | Sep 3, 2003 | 100% |
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Pontotoc Health & Rehab Center
- Skilled Nursing Facility
- Pontotoc, MS
- NPI 1548373665
Advanced Healthcare Management, Inc
-
dba New Albany Health & Rehab Center
- Skilled Nursing Facility
- New Albany, MS
- NPI 1922111004
Advanced Healthcare Management, Inc
-
dba Terrace Manor Nursing & Rehab Center
- Skilled Nursing Facility
- Russellville, AL
- NPI 1528085560
Advanced Healthcare Management, Inc
Practitioners & affiliated clinicians
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.
-
- Internal Medicine Physician
- Oxford, MS
- NPI 1295828614
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421280000000",
"number": "1124135827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 BELK BLVD",
"city": "OXFORD",
"state": "MS",
"postal_code": "386555301",
"telephone_number": "662-234-7821",
"fax_number": "662-234-0294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 BELK BLVD",
"city": "OXFORD",
"state": "MS",
"postal_code": "386555301",
"telephone_number": "662-234-7821",
"fax_number": "662-234-0294"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAFAYETTE LTC, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-25",
"last_updated": "2015-01-15",
"status": "A",
"authorized_official_last_name": "HUBBARD",
"authorized_official_first_name": "GENE",
"authorized_official_middle_name": "BENNETT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "601-849-2294",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MS",
"license": "185",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00230078",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Oxford Health & Rehab Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.