Organization Active NPI

Perry Community Care Center LLC

Doing business as Perry County Nursing Center

  • Skilled Nursing Facility
  • Richton, MS
National Provider Identifier
1225086648
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
650 Issued in MS
Legal business name
PERRY COMMUNITY CARE CENTER LLC
Doing business as
Perry County Nursing Center
Practice address
202 Bay Ave
Richton, MS 39476-2941
Phone
(601) 788-2490
Fax
(601) 788-2499
NPI assigned
May 5, 2006
Last updated
Oct 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 650 MS Primary

Addresses

Primary practice location

202 Bay Ave
Richton, MS 39476-2941

Mailing address

202 Bay Ave
Richton, MS 39476-2941
Phone (601) 788-2490

Other identifiers 2

IdentifierTypeStateIssuer
00230159MedicaidMS
80115OtherMSBLUE CROSS BLUE SHIELD

Other names 1

  • Perry County Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050124000628 MS Part A Provider - Skilled Nursing Facility 6002866589 Practice locations: Richton, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225086648. Details of each certification follow.

Skilled nursing facility certification: CCN 255159

Legal name
PERRY COMMUNITY CARE CENTER, LLC
Doing business as
PERRY COUNTY NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1992
Last certification
May 8, 2025
Beds
60
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Pathway Management LLC
Organization structure
LLCProprietary
Enrollment address
202 Bay Avenue West
Richton, MS 39476-2941
Nursing home name
PERRY COUNTY NURSING CENTER
Affiliated entity
THE BEEBE FAMILY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Perry County Nursing CenterCCN 255159 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6055.1 residents per day on average
Chain
The Beebe Family48 facilities in the chain

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
25D0993947Perry County Nursing Center202 Bay Avenue West, Richton, MS 39476Certificate of waiverNov 28, 2027

National Provider Directory

National Provider Directory

Locations

202 Bay Ave
Richton, MS 39476
Phone (601) 788-2490

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Hibernia Williams Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2025 15%
Adp of the SNF Jan 1, 2025
Extended Care Associates, Inc. Organization, Ridgeland, MS Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 80%
Operational/Managerial Control Jan 1, 2012
Pamela Williams Individual Operational/Managerial Control Dec 30, 2024
Dorothy Duckworth Individual Operational/Managerial Control Dec 30, 2022
Adp of the SNF Dec 30, 2022
Account Management Services Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Elton G Beebe Individual Operational/Managerial Control Jan 1, 2012
Adp of the SNF Jan 1, 2012
Indirect Ownership Interest Jul 15, 2025 100%
Regional Care LLC Organization, Ridgeland, MS LLC, For-profit Operational/Managerial Control Jan 1, 2023
Kari M Beasley Individual Operational/Managerial Control Apr 7, 2020
Adp of the SNF Apr 7, 2020
Linda Maynor Organization, Water Valley, MS Consulting firm Adp of the SNF Jan 1, 2011
Regional Services, Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2023
Timothy Duncan Estes Individual Operational/Managerial Control Apr 1, 2021
Adp of the SNF Apr 1, 2021
Elton G Beebe Sr Revocable Trust Organization, Ridgeland, MS 5% Or Greater Indirect Ownership Interest Jan 1, 2012 100%
Toni H Parkinson Individual Corporate OfficerPresident-Administrative Systems Jul 1, 2011
Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2020
Provider Professional Services Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Nutrition Systems Consulting Inc Organization, Ridgeland, MS Corporation Adp of the SNF Jan 31, 2008
Ann Belton Individual Adp of the SNF Jan 1, 2025
Administrative Systems Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Bobby L Beebe Individual Operational/Managerial Control Jan 1, 2023
Managing Control - Governing BodyPresident Jan 1, 2010
Trustee of the SNF Jan 1, 2010
Adp of the SNF Jan 1, 2023
Tristar Rehab Inc Organization, Homosassa, FL Corporation Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Bay Street Properties LLC Organization, Ridgeland, MS LLC Adp of the SNF Jan 1, 2025
Pharmaceutical Consulting Services of America LLC Organization, Baton Rouge, LA LLC Adp of the SNF Mar 28, 2018

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 50

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

View all 50

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1225086648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 BAY AVE",
            "city": "RICHTON",
            "state": "MS",
            "postal_code": "394762941",
            "telephone_number": "601-788-2490",
            "fax_number": "601-788-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 BAY AVE",
            "city": "RICHTON",
            "state": "MS",
            "postal_code": "394762941",
            "telephone_number": "601-788-2490",
            "fax_number": "601-788-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COMMUNITY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-10-28",
        "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": "650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230159",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80115",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry County Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richton, MS

Sources for this page

Verify at the official NPI Registry.