Pandora Redmond-Wills, RN

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Practice address

749 Main St
Greenville, MS 38701-4108

Phone

(662) 335-5554

Fax

(662) 335-5580

NPI assigned

May 23, 2019

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Mrs. Pandora Redmond Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PLC Professional Staffing Solutions, LLC

  • Nursing Care Agency
  • Greenville, MS
  • NPI 1962413997
  NPD (past)
• Professional Staffing Solutions Adult Day Services, LLC

  dba Professional Staffing Solutions

  • Adult Day Care Clinic/Center
  • Greenville, MS
  • NPI 1316452501
  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1760049829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4580",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044580",
            "telephone_number": "662-822-1924",
            "fax_number": "662-335-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 MAIN ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014108",
            "telephone_number": "662-335-5554",
            "fax_number": "662-335-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1633 Broadway Ext N",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MS",
            "postal_code": "387031942",
            "country_code": "US",
            "telephone_number": "662-822-1924",
            "fax_number": "662-335-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDMOND-WILLS",
        "first_name": "PANDORA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MS",
            "license": null,
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07331397",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08679792",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06908787",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pandora.redmond@gmail.com",
            "affiliation": "Y",
            "endpointDescription": "professional email",
            "affiliationName": "PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "749 Main St",
            "city": "Greenville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "387014108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PANDORA",
            "last_name": "REDMOND",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• James A Ray, APRN
• Jean Elizabeth Ray
• RB Medical Equipment, LLC (Charter Medical of Greenville)
• RCG Mississippi, Inc. (RCG Greenville)
• RCG of Dermott, LLC
• Regional Surgical Centre, Inc.
• Eric Lee Reimund, M.D.
• Reliable Trips
• Renia R Dotson MD PC
• Derek Scott Reno, NURSE PRACTITIONER

• Adult Day Care Clinic/Center in Greenville, MS
• Providers in Greenville, MS by specialty
• Adult Day Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.