Organization Active NPI

Platinum Plus Care

  • Assisted Living Facility
  • Indianola, MS
National Provider Identifier
1285179887
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
205593 Issued in MS
Legal business name
PLATINUM PLUS CARE
Practice address
617 Highway 82 W
Indianola, MS 38751-2056
Phone
(662) 445-2600
NPI assigned
Jan 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Miss Maple Lean Campbell
Title
Ceo
Phone
(662) 445-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 205593 MS Primary

Addresses

Primary practice location

617 Highway 82 W
Indianola, MS 38751-2056

Mailing address

PO Box 649
617 Higway 82 West
Indianola, MS 38751-0649
Phone (662) 445-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170519001656 MS Part B Supplier - Clinic/Group Practice 0749557825 Receives reassigned benefits from 1 practitioner
Practice locations: Indianola, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1285179887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "address_2": "617 HIGWAY 82 WEST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387510649",
            "telephone_number": "662-445-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 HIGHWAY 82 W",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512056",
            "telephone_number": "662-445-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PLUS CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MAPLE",
        "authorized_official_middle_name": "LEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-445-2600",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MS",
            "license": "205593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.