Care Management Group Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

179 Issued in MS

Legal business name

CARE MANAGEMENT GROUP INC

Doing business as

Billdora Nursing Home

Practice address

314 Enochs St
Tylertown, MS 39667-2716

Phone

(601) 876-2173

Fax

(601) 876-4904

NPI assigned

Dec 6, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tina L Ellis

Title

Comptroller

Phone

(601) 304-0980

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Billdora Nursing Home Doing business as

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184608804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 ENOCHS ST",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672716",
            "telephone_number": "601-876-2173",
            "fax_number": "601-876-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 ENOCHS ST",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672716",
            "telephone_number": "601-876-2173",
            "fax_number": "601-876-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE MANAGEMENT GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "601-304-0980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MS",
            "license": "179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230053",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Billdora Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Peter Andrew Bundgard, M.D.
• Robin Elizabeth Campbell, CNP
• Elizabeth Carey, PTA
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• Sharon Mitchell Collins, M.D.

• Assisted Living Facility in Tylertown, MS
• Providers in Tylertown, MS by specialty
• Assisted Living Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.