Active NPI
Stone County Rehabilitation and Nursing Center Inc
Doing business as Memorial Stone County Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Wiggins, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- STONE COUNTY REHABILITATION AND NURSING CENTER INC
- Doing business as
- Memorial Stone County Nursing & Rehabilitation Center
- Practice address
- 1436 Central Ave E
Wiggins, MS 39577-9602 - Phone
- (601) 928-1889
- Fax
- (601) 928-2335
- NPI assigned
- Oct 16, 2006
- Last updated
- Mar 29, 2022
- 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. Harold T Cain
- Title
- President
- Phone
- (228) 832-4220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1436 Central Ave E
Wiggins, MS 39577-9602
Mailing address
PO Box 246
Wiggins, MS 39577-0246
Phone (601) 928-1889
Other names 1
- Memorial Stone County Nursing & Rehabilitation 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 |
|---|---|---|---|---|
| O20220318000528 | MS | Part A Provider - Skilled Nursing Facility | 1456746098 | Practice locations: Wiggins, MS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1194815365. Details of each certification follow.
Skilled nursing facility certification: CCN 255308
- Legal name
- STONE COUNTY REHABILITATION AND NURSING CENTER, INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Apr 16, 2004
- Last certification
- Jan 25, 2024
- Beds
- 59
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 2, 2021 in MS
- Enrollment address
- 1436 E Central Ave
Wiggins, MS 39577-9602 - Nursing home name
- STONE COUNTY REHABILITATION AND NURSING CTR INC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Stone County Rehabilitation and Nursing Ctr Inc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 16, 2004
- Medicare certification status
- Active
- Certified beds
- 59
- Penalties (3 years)
- 2
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 |
|---|---|---|---|
| 25D1023331 | Stone County Rehabilitation and Nursing Center Inc | Certificate of waiver | Mar 14, 2028 |
National Provider Directory
National Provider DirectoryLocations
1436 Central Ave E
Wiggins, MS 39577
Phone (601) 928-1889
Ownership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Corporate Management, Inc. | Operational/Managerial Control | Mar 1, 2022 | 100% |
| Adp of the SNF | Mar 1, 2022 | ||
| Evan Trace Cain GST Trust | 5% Or Greater Direct Ownership Interest | Dec 2, 2021 | 49.5% |
| Trustee of the SNF | Dec 2, 2021 | ||
| Adp of the SNF | Dec 2, 2021 | ||
| Harold Theodore Cain | Corporate Officer | Dec 2, 2021 | 100% |
| Corporate Director | Dec 2, 2021 | 100% | |
| Direct Ownership Interest | Dec 2, 2021 | 1% | |
| Logan Patrick Cain GST Trust | 5% Or Greater Direct Ownership Interest | Dec 2, 2021 | 49.5% |
| Adp of the SNF | Dec 2, 2021 | ||
| Beth Gruzinskas | Operational/Managerial Control | Apr 3, 2025 | |
| Adp of the SNF | Apr 3, 2025 | ||
| Michael H Albert | Adp of the SNF | Jan 1, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Leakesville, MS
- NPI 1043543929
Corporate Management, Inc., Evan Trace Cain GST Trust, Logan Patrick Cain GST Trust
-
dba Memorial Woodland Village Nursing Center
- Skilled Nursing Facility
- Diamondhead, MS
- NPI 1619066248
Corporate 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.
-
- Family Medicine Physician
- Richland, MS
- NPI 1679562094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648512000000",
"number": "1194815365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 246",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395770246",
"telephone_number": "601-928-1889",
"fax_number": "601-928-2335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1436 CENTRAL AVE E",
"city": "WIGGINS",
"state": "MS",
"postal_code": "395779602",
"telephone_number": "601-928-1889",
"fax_number": "601-928-2335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STONE COUNTY REHABILITATION AND NURSING CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A",
"authorized_official_last_name": "CAIN",
"authorized_official_first_name": "HAROLD",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "228-832-4220",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Memorial Stone County Nursing & Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Wiggins, MS
- Stone County Hospital, Inc
- Stone County Hospital, Inc
- Stone County Hospital, Inc
- Stone County Hospital, Inc.
- Stone County Hospital, Inc. (Stone County Family Medical Clinic)
- Stone County School District
- Stone Dental Clinic
- Charles Ray Strange III
- Janet Elaine Strangi, M.D.
- Strickland Drugs LLC (County Discount Drug, Inc.)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.