Mississippi State Department of Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

9481 Issued in MS

Legal business name

MISSISSIPPI STATE DEPARTMENT OF HEALTH

Practice address

517 Church Street
Booneville, MS 38829

Phone

(662) 728-5391

Fax

(662) 728-0132

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Melanie Bowman, RN

Title

Director of Home Health

Phone

(601) 576-7853

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northeast Home Health Agency 2B Doing business as

Locations

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1467437210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CHURCH STREET",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "38829",
            "telephone_number": "662-728-5391",
            "fax_number": "662-728-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 CHURCH STREET",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "38829",
            "telephone_number": "662-728-5391",
            "fax_number": "662-728-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "DIRECTOR OF HOME HEALTH",
        "authorized_official_telephone_number": "601-576-7853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MS",
            "license": "9481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00070500",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Home Health Agency 2B",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Lynn Miles
• Brittany Alaina Crowell Miller, AGACNP-BC, FNP-C
• Catherine Johnson Mincy, DDS
• Kelsey Mink, FNP-C
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi State Department of Health
• Mockingbird Assisted Living, LLC
• Rebekah Abigail Moss, NP
• MSK Group, PC
• Amanda Mullins

• Home Health Agency in Booneville, MS
• Providers in Booneville, MS by specialty
• Home Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.