NPIMap

Organization Active NPI

Abundant Living Healthcare

  • Homemaker
  • Mound Bayou, MS
National Provider Identifier
1134471659
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
00530517 Issued in MS
Legal business name
ABUNDANT LIVING HEALTHCARE
Practice address
202 Green St
Mound Bayou, MS 38762-9762
Phone
(662) 741-3354
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Ms. Cassandra Camille Dancy, RN
Title
Administrator
Phone
(662) 347-9976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
HomemakerGroup: 193400000X SINGLE SPECIALTY GROUP 376J00000X 00530517 MS Primary

Addresses

Primary practice location

202 Green St
Mound Bayou, MS 38762-9762

Mailing address

125 Old Mound Bayou Rd
Mound Bayou, MS 38762-9591
Phone (662) 741-3354

Other identifiers 1

IdentifierTypeStateIssuer
00530517MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1134471659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 OLD MOUND BAYOU RD",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629591",
            "telephone_number": "662-741-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 GREEN ST",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387629762",
            "telephone_number": "662-741-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIVING HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "DANCY",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-347-9976",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": "MS",
            "license": "00530517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00530517",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mound Bayou, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.