Magnolia Senior Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

404 Issued in MS

Legal business name

MAGNOLIA SENIOR CARE LLC

Practice address

3701 Peter Quinn Dr
Jackson, MS 39213-3309

Phone

(601) 366-1712

Fax

(601) 366-1715

NPI assigned

Aug 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Tina Ellis

Title

Comptroller

Phone

(601) 366-1712

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Skilled nursing facility certification: CCN 255275

Legal name

MAGNOLIA SENIOR CARE LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 2001

Last certification

Dec 18, 2024

Beds

60

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Tillman Senior Care, LLC

Organization structure

LLCProprietary

Incorporated

Feb 1, 2007 in MS

Enrollment address

3701 Peter Quinn Dr
Jackson, MS 39213-3309

Nursing home name

MAGNOLIA SENIOR CARE, LLC

Listed as

Magnolia Senior Care, LLCCCN 255275 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 1, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6056.6 residents per day on average

Penalties (3 years)

2Fines totaling $8,542

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 5

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 2

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

• Timothy Duncan Estes, M.D.

  • General Practice Physician
  • Jackson, MS
  • NPI 1285746511

  Adp of the SNF

  CMS ownership
• Clifford Randolph Tillman

  • Gastroenterology Physician
  • Vidalia, LA
  • NPI 1053309732

  5% Or Greater Indirect Ownership Interest, Adp of the SNF

  CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Billdora Senior Care LLC

  • Skilled Nursing Facility
  • Tylertown, MS
  • NPI 1013109479

  Tillman Senior Care, LLC

  CMS ownership
• Lexington Manor Senior Care LLC

  • Skilled Nursing Facility
  • Lexington, MS
  • NPI 1063604320

  Tillman Senior Care, LLC

  CMS ownership

Practitioners 2

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

• Clifford Randolph Tillman

  • Gastroenterology Physician
  • Vidalia, LA
  • NPI 1053309732
  NPD
• Timothy Duncan Estes, M.D.

  • General Practice Physician
  • Jackson, MS
  • NPI 1285746511
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1427240779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 PETER QUINN DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392133309",
            "telephone_number": "601-366-1712",
            "fax_number": "601-366-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 PETER QUINN DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392133309",
            "telephone_number": "601-366-1712",
            "fax_number": "601-366-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "601-366-1712",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Crossing Mental Health Services LLC
• Magnolia Medical Foundation
• Magnolia Medical Group P a
• Magnolia Nursing Center LLC
• Magnolia Pines Elderly Care Services
• Magnolia Sitters, LLC
• Magnolia Speech School
• Magnolia Woman'S Clinic, P.a.
• Martha Magnuson, MD
• Justin Temple Mahaney, M.D.

• Skilled Nursing Facility in Jackson, MS
• Providers in Jackson, 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 Aug 10, 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.