Organization Active NPI

Stone County Rehabilitation and Nursing Center Inc

Doing business as Memorial Stone County Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Wiggins, MS
National Provider Identifier
1194815365
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 IncCCN 255308 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 16, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5943.9 residents per day on average
Penalties (3 years)
2Fines totaling $8,190

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1023331Stone County Rehabilitation and Nursing Center Inc1436 E Central Avenue, Wiggins, MS 39577Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Corporate Management, Inc. Organization, Gulfport, MS Corporation, Chain home office Operational/Managerial Control Mar 1, 2022 100%
Adp of the SNF Mar 1, 2022
Evan Trace Cain GST Trust Organization, Gulfport, MS 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 Individual Corporate OfficerPresident of Board Dec 2, 2021 100%
Corporate DirectorDirector Dec 2, 2021 100%
Direct Ownership Interest Dec 2, 2021 1%
Logan Patrick Cain GST Trust Organization, Gulfport, MS 5% Or Greater Direct Ownership Interest Dec 2, 2021 49.5%
Adp of the SNF Dec 2, 2021
Beth Gruzinskas Individual Operational/Managerial Control Apr 3, 2025
Adp of the SNF Apr 3, 2025
Michael H Albert Individual 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.

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.

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

Sources for this page

Verify at the official NPI Registry.