NPIMap

Organization Active NPI

Nevaeh Hospice

  • In Home Supportive Care Agency
  • Mound Bayou, MS
National Provider Identifier
1639890957
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
NEVAEH HOSPICE
Doing business as
Nevaeh Home Maker Service
Nevaeh Homemaker
Nevaeh Homemaker Service
Practice address
116 S Edward Ave.
116 S Edward Ave. Suite B
Mound Bayou, MS 38762-0010
Phone
(662) 719-2005
Fax
(662) 741-2006
NPI assigned
Sep 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Mrs. Beverly C JohnsonNPI 1891137873
Title
Administrator
Phone
(662) 719-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

116 S Edward Ave.
116 S Edward Ave. Suite B
Mound Bayou, MS 38762-0010

Mailing address

P.O. Box 10
1165 Edward Ave. Suite B
Mound Bayou, MS 38762-0010
Phone (662) 719-2005

Other names 3

  • Nevaeh Home Maker Service Doing business as
  • Nevaeh Homemaker Doing business as
  • Nevaeh Homemaker Service Doing business as

National Provider Directory

National Provider Directory

Locations

116 S Edwards Ave
Ste B
Mound Bayou, MS 38762
Phone (662) 719-2005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1639890957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10",
            "address_2": "1165 EDWARD AVE. SUITE B",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387620010",
            "telephone_number": "662-719-2005",
            "fax_number": "662-741-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S EDWARD AVE.",
            "address_2": "116 S EDWARD AVE. SUITE B",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "387620010",
            "telephone_number": "662-719-2005",
            "fax_number": "662-741-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVAEH HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-719-2005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevaeh Home Maker Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevaeh Homemaker",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevaeh Homemaker",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevaeh Homemaker Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mound Bayou, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.