Bedford Care Center of Mendenhall, LLC
Organization Active NPI Skilled Nursing Facility · Mendenhall, MS
NPI 1497737571 · NPPES record last updated Jan 15, 2010
Key facts
- NPI
- 1497737571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 600 (MS)
- Legal business name
- BEDFORD CARE CENTER OF MENDENHALL, LLC
- Practice address
- 925 Mangum Ave
Mendenhall, MS 39114-3026 - Phone
- (601) 847-1311
- Fax
- (601) 847-0857
- NPI assigned
- Nov 15, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Stephen A. Worrel
- Title
- Controller
- Phone
- (601) 583-3232
Facilities with the same owner 6
Practitioners 2
-
Chip D Holbrook, MD
-
Charles Pruitt, M.D.
Affiliated clinicians 3
-
Chip D Holbrook, MD
-
Charles Pruitt, M.D.
-
Harpal Singh, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Bedford Care Center of Mendenhall
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1992
- Medicare certification status
- Active
- Certified beds
- 60 · 55.9 residents per day on average
- Chain
- Bedford Care Centers
- Penalties (3 years)
- 5 · fines totaling $79,758
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0670169 | Bedford Care Center of Mendenhall | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Skilled nursing facility certification: CCN 255150
- Legal name
- BEDFORD CARE CENTER OF MENDENHALL LLC
- Doing business as
- THE NS GROUP
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1992
- Last certification
- Feb 6, 2025
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- HMP Management
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 26, 2001 in MS
- Enrollment address
- 925 Mangum Ave
Mendenhall, MS 39114-3026 - Nursing home name
- BEDFORD CARE CENTER OF MENDENHALL
- Affiliated entity
- BEDFORD CARE CENTERS
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Michael E. McElroy Family Trust Fbo Michael E. McElroy, Jr. |
5% Or Greater Indirect Ownership Interest | Apr 25, 2025 | 13% |
| Adp of the SNF | Apr 2, 2025 | ||
| Bedford Health Properties, LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2001 | 100% |
| Hattiesburg Medical Park Management Corp. |
Operational/Managerial Control | Nov 1, 2001 | |
| Adp of the SNF | Nov 1, 2001 | ||
| Rhonda Gibson |
Operational/Managerial Control | Jul 29, 1996 | |
| Adp of the SNF | Jul 29, 1996 | ||
| Heather Gilbert |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Jennifer L Ryals |
Adp of the SNF | May 4, 2006 | |
| |
Adp of the SNF | May 19, 2019 | |
| Charles Cooper Bevon |
Operational/Managerial Control | Jan 1, 2005 | |
| Adp of the SNF | Jan 1, 2005 | ||
| Jack Bevon |
Corporate Officer |
Jan 21, 2021 | |
| Corporate Director | Jan 21, 2021 | ||
| Michael McElroy |
5% Or Greater Indirect Ownership Interest |
Nov 1, 2001 | 24.5% |
| Corporate Officer |
Nov 1, 2001 | 24.5% | |
| Corporate Director |
Feb 15, 2022 | 24.5% | |
| Operational/Managerial Control | Feb 15, 2022 | ||
| Janet F McElroy Family Trust Fbo Nicole McElroy Bevon |
5% Or Greater Indirect Ownership Interest | Jan 27, 2025 | 12.5% |
| Adp of the SNF | Jan 1, 2025 | ||
| Indirect Ownership Interest | Jan 27, 2025 | 12.5% | |
| Janet F. McElroy Family Trust Fbo Michael E. McElroy, Jr. |
5% Or Greater Indirect Ownership Interest | Jan 27, 2025 | 12.5% |
| Adp of the SNF | Jan 27, 2025 | ||
| |
Adp of the SNF | Aug 20, 2015 | |
| Tambara Robbins |
Adp of the SNF | May 4, 2006 | |
| Nicole Bevon |
5% Or Greater Indirect Ownership Interest |
Nov 1, 2001 | 24.5% |
| Corporate Director | Dec 1, 2001 | 24.5% | |
| Richard D. Blackledge |
Operational/Managerial Control | May 4, 2016 | |
| Adp of the SNF | May 9, 2016 | ||
| Trustmark National Bank |
5% Or Greater Mortgage Interest | Jan 26, 2015 | 25.46% |
| Michael E McElroy Family Trust Fbo Nicole McElroy Bevon |
5% Or Greater Indirect Ownership Interest | Jan 27, 2025 | 13% |
| Adp of the SNF | Jan 27, 2025 | ||
| Forvis Mazars LLP |
Adp of the SNF | Dec 31, 2016 | |
| Robert Martin |
Operational/Managerial Control | Jun 8, 2022 | |
| Adp of the SNF | Jun 8, 2022 | ||
| |
Adp of the SNF | Nov 1, 2001 | |
| |
Adp of the SNF | May 21, 2025 | |
| Lisa Bean |
Operational/Managerial Control | Apr 28, 2008 | |
| Adp of the SNF | Apr 28, 2008 | ||
| Sonya McElroy |
Corporate Officer |
Jan 21, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091222000469 | MS | Part a Provider - Skilled Nursing Facility | 4789724709 | Practice locations: Mendenhall, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 600 | MS | Yes |
Addresses
Primary practice location
925 Mangum Ave
Mendenhall, MS 39114-3026
Mailing address
100 W Pine St
Hattiesburg, MS 39401-3467
Phone (601) 583-3232
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00230157 | Medicaid | MS | |
| 000080357 | Other | MS | BCBS PROVIDER NUMBER |
Other providers in Mendenhall, MS
- Alpha and Omega Health Services LLC
- Amnuey M Chiemprabha MD PA
- Anointed Hands Care LLC
- Deirdre Atkins
- Available Pharmaceutical Services
- Blue Dot Medical, Inc
- Jason Randel Bowen
- Meredith Brantley
- Rebecca Byrd Bridges
- Glenn A Brien Sr.
All providers in Mendenhall, MS · Skilled Nursing Facility in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.