NPIMap

Organization Active NPI

Smith County LTC, LLC

  • Nursing Facility/Intermediate Care Facility
  • Raleigh, MS
National Provider Identifier
1326178203
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
354 Issued in MS
Legal business name
SMITH COUNTY LTC, LLC
Practice address
309 Magnolia Drive
Raleigh, MS 39153
Phone
(601) 782-4244
Fax
(601) 782-9616
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Mrs. Tonya Nell Eubanks, CONTROLLER
Title
Controller
Phone
(662) 234-1520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 354 MS Primary

Addresses

Primary practice location

309 Magnolia Drive
Raleigh, MS 39153

Mailing address

309 Magnolia Drive
P. O. Box 128
Raleigh, MS 39153
Phone (601) 782-4244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141030000238 MS Part A Provider - Skilled Nursing Facility 8123249471 Practice locations: Raleigh, MS

Skilled nursing facility certification: CCN 255342

Legal name
SMITH COUNTY LTC, LLC
Doing business as
MISSISSIPPI CARE CENTER OF RALEIGH
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 19, 2015
Last certification
Feb 13, 2025
Beds
110
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Aug 15, 2014 in MS
Enrollment address
309 Magnolia Drive
Mississippi Care Center of Raleigh
Raleigh, MS 39153-6011
Nursing home name
MS CARE CENTER OF RALEIGH
Affiliated entity
MISSISSIPPI CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ms Care Center of RaleighCCN 255342
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 19, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11089.2 residents per day on average
Chain
Mississippi Care Center5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
SHR Investments, LLC Organization, Jackson, MS Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2014 66.7%
Richard E Keyes Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 33.33%
Rebecca H Shelton Individual Corporate OfficerCorporate Secretary Aug 15, 2014
Harold M Beebe Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 33.33%
Stephen Pace Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 33%
Harry Strohm Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 33%
Scott County Investments LLC Organization, Morton, MS Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2014 33.3%
Cleta Mullins Individual Adp of the SNF Nov 1, 2014
Steven L Delaney Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 33.33%
Rudolph S Runnels Individual Adp of the SNF Nov 1, 2014
Oxford Healthcare Management, Inc. Organization, Oxford, MS Corporation Operational/Managerial Control Nov 1, 2014 100%
Adp of the SNF Nov 1, 2014
Garry H Pace Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 34%
Operational/Managerial Control Nov 1, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 3

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1326178203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MAGNOLIA DRIVE",
            "address_2": "P. O. BOX 128",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "39153",
            "telephone_number": "601-782-4244",
            "fax_number": "601-782-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MAGNOLIA DRIVE",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "39153",
            "telephone_number": "601-782-4244",
            "fax_number": "601-782-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH COUNTY LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "EUBANKS",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "NELL",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "662-234-1520",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CONTROLLER"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MS",
            "license": "354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, MS

Sources for this page

Verify at the official NPI Registry.