Dugan Memorial Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

178 Issued in MS

Legal business name

DUGAN MEMORIAL HOME

Practice address

804 E Main St
West Point, MS 39773-3137

Phone

(662) 494-3640

Fax

(662) 494-3641

NPI assigned

Oct 5, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Tammy Shea Martin, ADMINISTRATOR

Title

Executive Director

Phone

(662) 494-3640

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336136241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397730698",
            "telephone_number": "662-494-3640",
            "fax_number": "662-494-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E MAIN ST",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397733137",
            "telephone_number": "662-494-3640",
            "fax_number": "662-494-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUGAN MEMORIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "SHEA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "662-494-3640",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25A411",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Dahlen, OTR-L
• Yashia Vashonda Davis, CNA
• Christopher Diggs
• Divinity Healthcare Inc
• Matthew Charles Dowdy, DO
• Dugan Memorial Home, Inc.
• Catherine Sandberg Eaves
• Charles H Emrick, NP
• Encore Rehabilitation Inc
• Encore Rehabilitation Inc

• All providers in West Point, MS
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.