Tishomingo Community Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

414 Issued in MS

Legal business name

TISHOMINGO COMMUNITY CARE CENTER LLC

Doing business as

Tishomingo Manor

Practice address

230 Kaki Ave
Iuka, MS 38852-1192

Phone

(662) 423-9112

Fax

(662) 423-9121

NPI assigned

May 5, 2006

Last updated

Apr 30, 2013By 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. Toni Parkinson

Title

Authorized Representative

Phone

(601) 709-1408

Specialties & licenses 1

Addresses

Other names 1

• Tishomingo Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194773515. Details of each certification follow.

• CCN 255218 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 255218

Legal name

TISHOMINGO COMMUNITY CARE CENTER, LLC

Doing business as

TISHOMINGO MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1996

Last certification

Apr 2, 2025

Beds

105

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

230 Kaki Street
Iuka, MS 38852-1115

Nursing home name

TISHOMINGO MANOR

Affiliated entity

THE BEEBE FAMILY

Listed as

Tishomingo ManorCCN 255218 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10599.7 residents per day on average

Chain

The Beebe Family48 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $29,145

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Margaret M Glynn, M.D.

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1750386488

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 54

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• American Legacy Properties LLC

  dba Legacy Manor Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Greenville, MS
  • NPI 1447208228

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Attala Community Care Center LLC

  dba Attala County Nursing Center

  • Skilled Nursing Facility
  • Kosciusko, MS
  • NPI 1215985429

  Account Management Services Inc, Administrative Systems Inc, Elton G Beebe Sr Irrv Grndchildrens TR, Providence Care LLC, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Care Givers, LLC

  dba Clarksdale Nursing Center

  • Skilled Nursing Facility
  • Clarksdale, MS
  • NPI 1740238930

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc

  CMS ownership
• Collins Community Care Center LLC

  dba Landmark of Collins

  • Skilled Nursing Facility
  • Collins, MS
  • NPI 1215985734

  Account Management Services Inc, Administrative Systems Inc, Elton G Beebe Sr Irrv Grndchildrens TR, Providence Care LLC, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Columbia Community Care Center LLC

  dba The Myrtles Nursing Center

  • Skilled Nursing Facility
  • Columbia, MS
  • NPI 1467400242

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Community Care Center of Aberdeen

  dba Care Center of Aberdeen

  • Skilled Nursing Facility
  • Aberdeen, MS
  • NPI 1063628451

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Community Care Center of Grenada, LLC

  dba Grenada Living Center

  • Skilled Nursing Facility
  • Grenada, MS
  • NPI 1477501922

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Community Care Center of Laurel, LLC

  dba Care Center of Laurel

  • Skilled Nursing Facility
  • Laurel, MS
  • NPI 1518094358

  Account Management Services Inc, Administrative Systems Inc, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Community Care Center of Vicksburg LLC

  dba Heritage House Nursing Center

  • Skilled Nursing Facility
  • Vicksburg, MS
  • NPI 1225086374

  Account Management Services Inc, Administrative Systems Inc, Providence Care LLC, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Copiah Community Care Center LLC

  dba Copiah Living Center

  • Skilled Nursing Facility
  • Crystal Springs, MS
  • NPI 1720036916

  Account Management Services Inc, Administrative Systems Inc, Elton G Beebe Sr Irrv Grndchildrens TR, Providence Care LLC, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Desoto Community Care Center LLC

  dba Landmark of Desoto

  • Skilled Nursing Facility
  • Horn Lake, MS
  • NPI 1831147677

  Account Management Services Inc, Administrative Systems Inc, Elton G Beebe Sr Irrv Grndchildrens TR, Elton G. Beebe Sr Irrv Childrens TR, Providence Care LLC, Provider Professional Services Inc, Regional Services, Inc, Tristar Rehab Inc

  CMS ownership
• Gulfport Healthcare LLC

  dba Gulfport Care Center

  • Skilled Nursing Facility
  • Gulfport, MS
  • NPI 1538582143

  Account Management Services Inc, Administrative Systems Inc, Providence Care LLC, Provider Professional Services Inc, Tristar Rehab Inc

  CMS ownership

Practitioners 5

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.

• Kaycee Renee Burcham, MD

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1518464080
  NPD (past)
• Margaret M Glynn, M.D.

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1750386488
  NPD (past)
• Jessica Suzanne Jensen, MD

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1013402254
  NPD (past)
• Ben Earl Kitchens, MD

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1912979592
  NPD (past)
• Donald Charles Robertson, DO

  • Internal Medicine Physician
  • Iuka, MS
  • NPI 1538297593
  NPD (past)

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kaycee Renee Burcham, MD

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1518464080

  Nursing home

  Care Compare affiliation
• Margaret M Glynn, M.D.

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1750386488

  Nursing home

  Care Compare affiliation
• Jessica Suzanne Jensen, MD

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1013402254

  Nursing home

  Care Compare affiliation
• Ben Earl Kitchens, MD

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1912979592

  Nursing home

  Care Compare affiliation
• Bradley Alton Murray, MD

  • Family Medicine Physician
  • Iuka, MS
  • NPI 1518451129

  Nursing home

  Care Compare affiliation
• Donald Charles Robertson, DO

  • Internal Medicine Physician
  • Iuka, MS
  • NPI 1538297593

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1194773515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 KAKI AVE",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521192",
            "telephone_number": "662-423-9112",
            "fax_number": "662-423-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 KAKI AVE",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521192",
            "telephone_number": "662-423-9112",
            "fax_number": "662-423-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISHOMINGO COMMUNITY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "PARKINSON",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "601-709-1408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tishomingo Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeannie Swann, MA
• Kylee Tapp, MSW, PCMHT
• Sheila Taylor, NP
• Tanechi Temple
• Pamela Thompson, FNP-BC
• Tishomingo Health Services, Inc. (Iuka Hospital)
• Tishomingo Health Services, Inc. (Tishomingo Health Services)
• Tishomingo Health Services, Inc. (Tishomingo Co Hospital)
• Tishomingo Health Services, Inc. (Tishomingo Health Swing Bed)
• Tishomingo Health Services, Inc. (Pulmonary Consultants Iuka)

• Skilled Nursing Facility in Iuka, MS
• Providers in Iuka, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.

Verify at the official NPI Registry.