NPIMap

Organization Active NPI

Tunica Adult Day Care

  • Exclusive Provider Organization
  • Tunica, MS
National Provider Identifier
1497007207
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
NONE REQUIRED Issued in MS
Legal business name
TUNICA ADULT DAY CARE
Practice address
1530 Edwards Ave
Tunica, MS 38676-9372
Phone
(662) 363-2001
NPI assigned
Oct 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
Mr. Billy J Willis
Title
Assistant Administrator
Phone
(662) 363-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X NONE REQUIRED MS Primary

Addresses

Primary practice location

1530 Edwards Ave
Tunica, MS 38676-9372

Mailing address

PO Box 2774
Tunica, MS 38676-2774
Phone (662) 363-2001

National Provider Directory

National Provider Directory

Locations

1530 Edwards Ave
Tunica, MS 38676
Phone (662) 363-2001

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1497007207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2774",
            "city": "TUNICA",
            "state": "MS",
            "postal_code": "386762774",
            "telephone_number": "662-363-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 EDWARDS AVE",
            "city": "TUNICA",
            "state": "MS",
            "postal_code": "386769372",
            "telephone_number": "662-363-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNICA ADULT DAY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "662-363-2001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MS",
            "license": "NONE REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tunica, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.