Organization Active NPI

Copiah Community Care Center LLC

Doing business as Copiah Living Center

  • Skilled Nursing Facility
  • Crystal Springs, MS
National Provider Identifier
1720036916
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
949 Issued in MS
Legal business name
COPIAH COMMUNITY CARE CENTER LLC
Doing business as
Copiah Living Center
Practice address
806 W Georgetown St
Crystal Springs, MS 39059-9453
Phone
(601) 892-1881
Fax
(601) 892-1985
NPI assigned
May 4, 2006
Last updated
Apr 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Mrs. Toni Parkinson
Title
Authorized Representative
Phone
(601) 709-1408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 949 MS Primary

Addresses

Primary practice location

806 W Georgetown St
Crystal Springs, MS 39059-9453

Mailing address

806 W Georgetown St
Crystal Springs, MS 39059-9453
Phone (601) 892-1881

Other identifiers 2

IdentifierTypeStateIssuer
80413OtherMSBLUE CROSS BLUE SHIELD
00230165MedicaidMS

Other names 1

  • Copiah Living Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071220000212 MS Part A Provider - Skilled Nursing Facility 2668562109 Practice locations: Crystal Springs, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720036916. Details of each certification follow.

Skilled nursing facility certification: CCN 255291

Legal name
COPIAH COMMUNITY CARE CENTER, LLC
Doing business as
COPIAH LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 2002
Last certification
May 8, 2025
Beds
60
Ownership / control type
Corporation
Organization structure
LLCProprietary
Enrollment address
806 W Georgetown St
Crystal Springs, MS 39059-9453
Nursing home name
COPIAH LIVING CENTER
Affiliated entity
THE BEEBE FAMILY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Copiah Living CenterCCN 255291 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6051.0 residents per day on average
Chain
The Beebe Family48 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0992552Copiah Living Center806 W Georgetown Street, Crystal Springs, MS 39059Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory

Locations

806 W Georgetown St
Crystal Springs, MS 39059
Phone (601) 473-6915

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Elton G Beebe Sr Irrv Grndchildrens TR Organization, Ridgeland, MS Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2010 15%
Bobby Blackard Individual Operational/Managerial Control Sep 16, 2021
Adp of the SNF Sep 16, 2021
QSST TR for Alison Beebe Sadler Danos and Her Descendants Organization, Ridgeland, MS 5% Or Greater Indirect Ownership Interest Nov 1, 2013 28.34%
Adp of the SNF Jan 1, 2025
Medico LLC Organization, Ridgeland, MS LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2010 85%
Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2025
Copiah Community Care Center, LLC Organization, Ridgeland, MS LLC Adp of the SNF Jan 1, 2025
Account Management Services Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Regional Care LLC Organization, Ridgeland, MS LLC, For-profit Operational/Managerial Control Jan 1, 2014
Elton G Beebe Individual 5% Or Greater Indirect Ownership InterestMember Jan 1, 2010 28.33%
Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2025
Robert L Walker Individual Operational/Managerial Control Sep 27, 2010
Adp of the SNF Sep 27, 2010
Linda Maynor Organization, Water Valley, MS Consulting firm Adp of the SNF Jan 1, 2011
Regional Services, Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Toni H Parkinson Individual Corporate OfficerPresident - Administrative Syste Nov 15, 2015
Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Provider Professional Services Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Lizabeth Gallagher Individual Operational/Managerial Control Feb 15, 2022
Nutrition Systems Consulting Inc Organization, Ridgeland, MS Corporation Adp of the SNF Jan 31, 2008
Administrative Systems Inc Organization, Ridgeland, MS Corporation Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
David W Stallard Individual Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Bobby L Beebe Individual Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Providence Care LLC Organization, Mandeville, LA LLC Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Tristar Rehab Inc Organization, Homosassa, FL Corporation Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
David a Flippin Individual Operational/Managerial ControlField Manager Through Regional C Jan 1, 2014
QSST TR for Felicia Beebe Stallard and Her Descendants Organization, Ridgeland, MS 5% Or Greater Indirect Ownership Interest Nov 1, 2013 28.33%
Adp of the SNF Jan 1, 2025
Pharmaceutical Consulting Services of America LLC Organization, Baton Rouge, LA LLC Adp of the SNF Mar 28, 2018

Owners & managing parties with NPI records 1

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

Facilities with the same owner 55

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

View all 55

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 4

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1720036916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 W GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390599453",
            "telephone_number": "601-892-1881",
            "fax_number": "601-892-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W GEORGETOWN ST",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390599453",
            "telephone_number": "601-892-1881",
            "fax_number": "601-892-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPIAH COMMUNITY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "PARKINSON",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "601-709-1408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80413",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230165",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copiah Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crystal Springs, MS

Sources for this page

Verify at the official NPI Registry.