Arden of North Mississippi, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ARDEN OF NORTH MISSISSIPPI, LLC

Doing business as

Arden of North Mississippi-Olive Branch

Practice address

9035 E Sandidge Rd Ste 102
Olive Branch, MS 38654-3563

Phone

(662) 893-5662

Fax

(662) 893-5664

NPI assigned

Jun 14, 2023

Last updated

Jun 14, 2023By 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

Wilford A Payne III

Title

President/Ceo

Phone

(601) 582-6031

Specialties & licenses 1

Addresses

Other names 1

• Arden of North Mississippi-Olive Branch Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437833878. Details of each certification follow.

• CCN 251567 Hospice · Active · Details

Hospice certification: CCN 251567

Legal name

ARDEN OF NORTH MISSISSIPPI LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 5, 2001

Last certification

Mar 4, 2021

Ownership / control type

Proprietary - Individual

Most recent change of ownership

Jun 30, 2023

Organization structure

LLCProprietary

Enrollment address

405 Galleria Lane
Ste C
Oxford, MS 38655-4717

Listed as

Arden of North Mississippi (Oxford)CCN 251567 · All quality measures

Ownership

For-Profit

Certified

Oct 5, 2001

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 16

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

Facilities with the same owner 5

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

• Arden Home Health of North Mississippi LLC

  • Home Health Agency
  • Oxford, MS
  • NPI 1093555344

  Arden Home Health and Hospice LLC, Mayfair Management LLC, Payne Camellia Family Trust, Payne Capital LLC, Payne Opportunity Fund LLC, Wilford a Payne III Childrens TR Ua, Wilford a Payne Jr Family Trust U/a 6/2/2020, Wilford a Paynejrgrantor Trust

  CMS ownership
• Arden of Central Mississippi, LLC

  dba Arden Hospice of Central Mississippi- Ridgeland

  • Community Based Hospice Care Agency
  • Ridgeland, MS
  • NPI 1174215750

  Arden Home Health and Hospice LLC, Mayfair Management LLC, Payne Camellia Family Trust, Payne Capital LLC, Payne Opportunity Fund LLC, Wilford a Payne III Childrens TR Ua, Wilford a Payne Jr Family Trust U/a 6/2/2020, Wilford a Paynejrgrantor Trust

  CMS ownership
• Arden of South Mississippi, LLC

  dba Arden of South Mississippi-Poplarville

  • Community Based Hospice Care Agency
  • Poplarville, MS
  • NPI 1982388377

  Arden Home Health and Hospice LLC, Mayfair Management LLC, Payne Camellia Family Trust, Payne Capital LLC, Payne Opportunity Fund LLC, Wilford a Payne III Childrens TR Ua, Wilford a Payne Jr Family Trust U/a 6/2/2020, Wilford a Paynejrgrantor Trust

  CMS ownership
• Arden Hospice of Southern Tennessee, LLC

  • Community Based Hospice Care Agency
  • Linden, TN
  • NPI 1912747577

  Arden Home Health and Hospice LLC, Mayfair Management LLC, Payne Camellia Family Trust, Payne Opportunity Fund LLC, Wilford a Payne III Childrens TR Ua, Wilford a Payne Jr Family Trust U/a 6/2/2020, Wilford a Paynejrgrantor Trustu/a 12/17/2020

  CMS ownership
• CCC Hospice LLC

  dba Bella Hospice of Texas

  • Community Based Hospice Care Agency
  • Mesquite, TX
  • NPI 1609504844

  Mayfair Management LLC

  CMS ownership

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Unity Hospice Care, LLC

  • Community Based Hospice Care Agency
  • Olive Branch, MS
  • NPI 1891764890

  Acquired from, 2023-06-30

  CMS change of ownership

Practitioners 7

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.

• Jennifer Olivia Barnes, FNP-BC

  • Family Nurse Practitioner
  • New Albany, MS
  • NPI 1366523284
  NPD
• Elizabeth Hill, FNP-C

  • Family Nurse Practitioner
  • Vicksburg, MS
  • NPI 1326434564
  NPD
• Randall T Huling, MD

  • Family Medicine Physician
  • Olive Branch, MS
  • NPI 1316936917
  NPD
• Vanessa N Satterwhite, DNP, FNP-C, PMHNP-BC

  • Family Nurse Practitioner
  • Tupelo, MS
  • NPI 1285043612
  NPD
• Gena Anne Vail, CFNP

  • Family Nurse Practitioner
  • New Albany, MS
  • NPI 1649204629
  NPD
• Sarah M Haskins, F.N.P.C.

  • Nurse Practitioner
  • Anoka, MN
  • NPI 1386058246
  NPD
• Ralph Sumner Abraham IV, M.D.

  • Internal Medicine Physician
  • Tupelo, MS
  • NPI 1881049443
  NPD (past)

Affiliated clinicians 2

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

• Ralph Sumner Abraham IV, M.D.

  • Internal Medicine Physician
  • Tupelo, MS
  • NPI 1881049443

  Hospice

  Care Compare affiliation
• Troy Reuben Cappleman, MD

  • Family Medicine Physician
  • New Albany, MS
  • NPI 1952371387

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1437833878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MAYFAIR RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021464",
            "telephone_number": "601-582-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 E SANDIDGE RD STE 102",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543563",
            "telephone_number": "662-893-5662",
            "fax_number": "662-893-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDEN OF NORTH MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "WILFORD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "601-582-6031",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arden of North Mississippi-Olive Branch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula Jean Allen, LPC
• Alleviate Medical Corp
• Holly Hacker Alverson, PHARM D
• Amber-Leigh Management Corp
• American Family Dentistry of Memphis, PC (American Family Dentistry Olive Branch)
• Jesse Armour, LMSW
• Jennifer M Ashley, DO
• Asm Inc (Mike's Pharmacy, A Memeber of the Medicine Shoppe Family)
• James Evan Bailey, DMD
• Kristen Marie Bailey, NP-C

• Community Based Hospice Care Agency in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Community Based Hospice Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.