Dunbar Village L.P.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

855 Issued in MS

Legal business name

DUNBAR VILLAGE L.P.

Practice address

725 Dunbar Ave
Bay St Louis, MS 39520-2920

Phone

(228) 466-3099

Fax

(228) 466-3994

NPI assigned

Apr 10, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Cameron Dirk Goddard

Title

Ar Manager

Phone

(601) 824-9010

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689897795. Details of each certification follow.

• CCN 255322 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 255322

Legal name

DUNBAR VILLAGE L.P.

Doing business as

DUNBAR VILLAGE TERRACE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 5, 2007

Last certification

Jan 19, 2024

Beds

60

Ownership / control type

Partnership

Organization structure

PartnershipProprietary

Enrollment address

725 Dunbar Ave
Dunbar Village Terrace
Bay Saint Louis, MS 39520-2920

Nursing home name

DUNBAR VILLAGE TERRACE

Listed as

Dunbar Village TerraceCCN 255322 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Partnership

Certified

Sep 5, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6056.0 residents per day on average

Penalties (3 years)

1Fines totaling $8,021

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Timothy Kipper Copeland, MD

  • Internal Medicine Physician
  • Bay St Louis, MS
  • NPI 1780188151

  Adp of the SNF

  CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Sentry-Gautier, Inc.

  dba River Chase Village

  • Nursing Facility/Intermediate Care Facility
  • Gautier, MS
  • NPI 1962508119

  Sentrycare Inc

  CMS ownership
• Professional Rehabilitation Hospital LLC

  dba RiverBridge Specialty Hospital

  • Long Term Care Hospital
  • Vidalia, LA
  • NPI 1518929926

  Sentrycare Inc

  CMS ownership

Practitioners 1

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.

• Timothy Kipper Copeland, MD

  • Internal Medicine Physician
  • Bay St Louis, MS
  • NPI 1780188151
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Timothy Kipper Copeland, MD

  • Internal Medicine Physician
  • Bay St Louis, MS
  • NPI 1780188151

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1689897795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106A OFFICE PARK DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 DUNBAR AVE",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395202920",
            "telephone_number": "228-466-3099",
            "fax_number": "228-466-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNBAR VILLAGE L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "DIRK",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "601-824-9010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230081",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Bay St Louis, MS
• Providers in Bay St Louis, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.

Verify at the official NPI Registry.