Madison County Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

187 Issued in MS

Legal business name

MADISON COUNTY NURSING HOME

Practice address

1421A E Peace St
Canton, MS 39046-4938

Phone

(601) 855-5760

NPI assigned

Jan 12, 2007

Last updated

Mar 23, 2010By 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. Daniel Logan

Title

Administrator

Phone

(601) 855-5771

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 1750431391. Details of each certification follow.

• CCN 255329 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 255329

Legal name

MADISON COUNTY NURSING HOME

Doing business as

MADISON COUNTY NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 2010

Last certification

Jul 10, 2024

Beds

95

Ownership / control type

County

Organization structure

GovernmentNon-profit

Enrollment address

1421A East Peace Street
Canton, MS 39046-4938

Nursing home name

MADISON CO NH

Listed as

Madison Co NHCCN 255329 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Jan 1, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9589.4 residents per day on average

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $8,278

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Madison County General Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Madison County General Hospital

  dba Madison County Nursing Home

  • Skilled Nursing Facility
  • Canton, MS
  • NPI 1255547618
  NPD tax ID

Locations

All disclosed owners & managing parties 5

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

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.

• Parvesh K Goel, M.D.

  • Internal Medicine Physician
  • Canton, MS
  • NPI 1548219082
  NPD (past)
• L C Tennin Jr., MD

  • Internal Medicine Physician
  • Canton, MS
  • NPI 1275543597
  NPD (past)

Affiliated clinicians 1

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

• Parvesh K Goel, M.D.

  • Internal Medicine Physician
  • Canton, MS
  • NPI 1548219082

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1750431391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421A E PEACE ST",
            "address_2": "P.O. BOX 488",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464938",
            "telephone_number": "601-855-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421A E PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464938",
            "telephone_number": "601-855-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-855-5771",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00023095",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Akers Lynch
• Nicole M Mack
• Madison Ambulatory Surgery Center, LLC
• Madison County Citizens Services Agency
• Madison County General Hospital (Madison County Nursing Home)
• Madison Emergency Group LLC
• Madison Hma (Patients Choice Senior Care of Madison County)
• Madison Hma LLC
• Madison Hma LLC (Merit Health Madison)
• Madison Hma Physician Management LLC

• Skilled Nursing Facility in Canton, MS
• Providers in Canton, 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 Mar 23, 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.

Verify at the official NPI Registry.