St. Jude Hospice Mississippi, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

094 Issued in MS

Legal business name

ST. JUDE HOSPICE MISSISSIPPI, LLC

Practice address

3166 W Jackson St
Suite # 2
Tupelo, MS 38801-7154

Phone

(662) 841-5907

Fax

(662) 841-5910

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas J Moreland

Title

Ceo

Phone

(515) 221-9155

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1750471942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13375 UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258261",
            "telephone_number": "515-221-9155",
            "fax_number": "515-221-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3166 W JACKSON ST",
            "address_2": "SUITE # 2",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388017154",
            "telephone_number": "662-841-5907",
            "fax_number": "662-841-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE HOSPICE MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-221-9155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03504070",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise Moorefield Spencer, MD
• Kendrick Spight
• Spine & Sports Medicine Center PLLC
• Michael Edward Spradling, CADC
• Amber St Rose
• Mary D Stacy, LMSW
• Andrea Standifer
• Keyaira Standifer
• Stephanie Lashone Stanfield
• Jane Whinery Stanford, M.S. ,CCC-SLP

• Community Based Hospice Care Agency in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Community Based Hospice Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.