Stevenson Prescott

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

0000 Issued in MS

Practice address

314 Old Ruleville Rd
Cleveland, MS 38732-9592

Phone

(662) 347-1122

NPI assigned

Feb 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Cleveland Adult Daycare

  • Adult Day Care Clinic/Center
  • Cleveland, MS
  • NPI 1639558588
  NPD (past) Authorized official

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1629460662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SMITH CV",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387324062",
            "telephone_number": "662-719-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 OLD RULEVILLE RD",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387329592",
            "telephone_number": "662-347-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "STEVENSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "MS",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHC-Cleveland LLC (Bolivar Medical Center)
• PHC-Cleveland, Inc. (Bolivar Medical Center Skilled Nursing Unit)
• Roenikya L. Phillips, DMD, MPH
• Michael E Portner, MD
• Susan Prather, CFNP
• Mary Elizabeth Prestage, M.A.
• Julie Manning Price, OT
• Prime Care Hospice, Inc. (Community Hospice Care)
• Dewayne Troy Proctor
• Raanne Ray Tindle D.M.D., P.a.

• Personal Care Attendant in Cleveland, MS
• Providers in Cleveland, MS by specialty
• Personal Care Attendant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.