Million Pines Personal Care Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MILLION PINES PERSONAL CARE HOME, LLC

Practice address

115 Dodd Cir
Statesboro, GA 30461-0628

Phone

(478) 463-5812

Fax

(877) 912-3006

NPI assigned

Aug 17, 2022

Last updated

Aug 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jimmie Sue Bland, MS

Title

Administrator

Phone

(478) 463-5812

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Jimmie Sue Sasser, ATC

  • Athletic Trainer
  • Dublin, GA
  • NPI 1124233374
  NPD

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1326766148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411",
            "city": "MOUNT VERNON",
            "state": "GA",
            "postal_code": "304450411",
            "telephone_number": "478-463-5812",
            "fax_number": "877-912-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 DODD CIR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610628",
            "telephone_number": "478-463-5812",
            "fax_number": "877-912-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLION PINES PERSONAL CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "BLAND",
        "authorized_official_first_name": "JIMMIE SUE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-463-5812",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JIMMIESUE@MILLIONPINESPCH.COM",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "address_1": "115 Dodd Cir",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304610628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• April Miller, ED.S., LPC, RPT-S
• Dawn Miller
• Grace P Miller, RN
• Sarah Miller, RBT
• Victoria D Miller
• Rachael Mitchell
• Joshua Timothy Mizelle
• Carly Mock
• Kiana C Moncur
• Makenzie Lee Moody, CCC-SLP

• Assisted Living Facility in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.