Active NPI
Bedford Care Center of Mendenhall, LLC
- Skilled Nursing Facility
- Mendenhall, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 600
- 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
- Last updated
- Jan 15, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stephen A. Worrel
- Title
- Controller
- Phone
- (601) 583-3232
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 600 | MS | Primary |
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 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000080357 | Other | MS | BCBS PROVIDER NUMBER |
| 00230157 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091222000469 | MS | Part A Provider - Skilled Nursing Facility | 4789724709 | Practice locations: Mendenhall, MS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1497737571. Details of each certification follow.
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
- 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
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bedford Care Center of Mendenhall
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1992
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- Bedford Care Centers
- Penalties (3 years)
- 5
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0670169 | Bedford Care Center of Mendenhall | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
100 W Pine St
Hattiesburg, MS 39401
925 Mangum Ave
Mendenhall, MS 39114
Phone (601) 847-1311
Ownership & related parties
All disclosed owners & managing parties 24
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| 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 |
Facilities with the same owner 6
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Hattiesburg, MS
- NPI 1811979990
Hattiesburg Medical Park Management Corp., Janet F McElroy Family Trust Fbo Nicole McElroy Bevon, Janet F. McElroy Family Trust Fbo Michael E. McElroy, Jr., Michael E McElroy Family Trust Fbo Nicole McElroy Bevon, Michael E. McElroy Family Trust Fbo M
-
- Skilled Nursing Facility
- Marion, MS
- NPI 1215170832
Bedford Health Properties, LLC
-
- Skilled Nursing Facility
- Newton, MS
- NPI 1356323430
Bedford Health Properties, LLC, Janet F McElroy Family Trust Fbo Nicole McElroy Bevon, Michael E McElroy Family Trust Fbo Nicole McElroy Bevon, Michael E. McElroy Family Trust Fbo Michael E. McElroy, Jr.
-
- Skilled Nursing Facility
- Petal, MS
- NPI 1235111311
Bedford Health Properties, LLC, Janet F McElroy Family Trust Fbo Nicole McElroy Bevon, Janet F. McElroy Family Trust Fbo Michael E. McElroy, Jr., Michael E McElroy Family Trust Fbo Nicole McElroy Bevon, Michael E. McElroy Family Trust Fbo Michael E. M
-
- Skilled Nursing Facility
- Hattiesburg, MS
- NPI 1578545646
Bedford Health Properties, LLC, Hattiesburg Medical Park Management Corp., Janet F McElroy Family Trust Fbo Nicole McElroy Bevon, Janet F. McElroy Family Trust Fbo Michael E. McElroy, Jr., Michael E McElroy Family Trust Fbo Nicole McElroy Bevon, Mich
-
dba Bedford Care Center of Picayune
- Skilled Nursing Facility
- Picayune, MS
- NPI 1417332040
Bedford Health Properties, LLC, Hattiesburg Medical Park Management Corp., Janet F McElroy Family Trust Fbo Nicole McElroy Bevon, Janet F. McElroy Family Trust Fbo Michael E. McElroy, Jr., Michael E McElroy Family Trust Fbo Nicole McElroy Bevon, Mich
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Mendenhall, MS
- NPI 1962546192
-
- Family Medicine Physician
- Magee, MS
- NPI 1700978889
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1263513600000",
"number": "1497737571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W PINE ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394013467",
"telephone_number": "601-583-3232",
"fax_number": "601-582-7539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 MANGUM AVE",
"city": "MENDENHALL",
"state": "MS",
"postal_code": "391143026",
"telephone_number": "601-847-1311",
"fax_number": "601-847-0857"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEDFORD CARE CENTER OF MENDENHALL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-15",
"last_updated": "2010-01-15",
"status": "A",
"authorized_official_last_name": "WORREL",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "601-583-3232",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MS",
"license": "600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "000080357",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00230157",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mendenhall, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.