Wisteria Gardens, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WISTERIA GARDENS, LLC

Practice address

5420 Highway 80 E
Pearl, MS 39208-8924

Phone

(601) 988-6800

NPI assigned

Sep 12, 2007

Organization subpart

No

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

Authorized official

Name

William D Hill Jr.

Title

Administrator

Phone

(601) 988-6800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Skilled nursing facility certification: CCN 255325

Legal name

WISTERIA GARDENS, LLC

Doing business as

WISTERIA GARDENS

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Mar 31, 2008

Last certification

Feb 20, 2025

Beds

52

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Sep 12, 2007

Enrollment address

5420 Highway 80 East
Wisteria Gardens
Pearl, MS 39208-8924

Nursing home name

WISTERIA GARDENS

Listed as

Wisteria GardensCCN 255325

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare

Ownership

For profit - Limited Liability company

Certified

Mar 31, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5244.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 13

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.

• Michael Holger Albert, MD

  • Family Medicine Physician
  • Richland, MS
  • NPI 1679562094

  Adp of the SNF, Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Michael Holger Albert, MD

  • Family Medicine Physician
  • Richland, MS
  • NPI 1679562094

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1306031372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 HIGHWAY 80 E",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088924",
            "telephone_number": "601-988-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 HIGHWAY 80 E",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088924",
            "telephone_number": "601-988-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISTERIA GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-988-6800",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth H Whitley, LPC,LMFT
• Amy Louise Williams, RDH
• Mary Alison Williams, LPC
• Tralicia Annreell Willingham
• Monika V Wilson
• Carol Elizabeth Woods, LMFT
• Roderick Onessimus Woods, CPSS
• Kevin Woodson Jr., REGISTERED NURSE
• Xcel Rehab, Inc.
• Selena A Yeager, ATC

• Skilled Nursing Facility in Pearl, MS
• Providers in Pearl, 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 Sep 12, 2007; 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.