St. John'S Personal Care Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ST. JOHN'S PERSONAL CARE SERVICES, LLC

Practice address

517 E Baker St
Indianola, MS 38751-2503

Phone

(166) 264-7766

NPI assigned

Jul 21, 2015

Organization subpart

No

Name

Mr. Willie Bradford, Jr

Title

Managing Director

Phone

(662) 647-1766

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

• St John'S Personal Care Services LLC

  • In Home Supportive Care Agency
  • Indianola, MS
  • NPI 1477920999
  NPD tax ID

Tax ID family

St John'S Personal Care Services LLC (2 organizations share this tax ID)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 3, 2016.

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1750766697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "address_2": "409 STATE STREET",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387510000",
            "telephone_number": "662-647-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E BAKER ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512503",
            "telephone_number": "166-264-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S PERSONAL CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "BRADFORD, JR",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "662-647-1766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Sunflower County Hospital
• South Sunflower County Hospital
• South Sunflower County Hospital
• St John'S Adult Day Services, LLC
• St John'S Personal Care Services LLC
• St. John'S Respite Care Services, LLC
• St. John'S Respite Care Services, LLC
• Sherman Christian Stauffer III, DNP, CRNA
• Katie Shea Stephens, RDH
• Sunflower-Humphreys Counties Progress, Inc.

• All providers in Indianola, MS
• In Home Supportive Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.