Peace Wellness Mobile Unit

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

PEACE WELLNESS MOBILE UNIT

Practice address

502 Mulberry St
Rear BLDG
Vaiden, MS 39176-9648

Phone

(601) 292-7015

Fax

(866) 884-6508

NPI assigned

May 5, 2017

Last updated

May 5, 2017By 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

Tracy Peeples

Title

Owner

Phone

(601) 292-7015

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Peace Wellness Mobile Unit2 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.

• Peace Wellness Mobile Unit

  • Early Intervention Provider Agency
  • Durant, MS
  • NPI 1831460591
  NPD tax ID

Locations

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493942400000",
    "number": "1770019036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MULBERRY ST",
            "address_2": "REAR BLDG",
            "city": "VAIDEN",
            "state": "MS",
            "postal_code": "391769648",
            "telephone_number": "601-292-7015",
            "fax_number": "866-884-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MULBERRY ST",
            "address_2": "REAR BLDG",
            "city": "VAIDEN",
            "state": "MS",
            "postal_code": "391769648",
            "telephone_number": "601-292-7015",
            "fax_number": "866-884-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE WELLNESS MOBILE UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A",
        "authorized_official_last_name": "PEEPLES",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-292-7015"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09753895",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Johnson
• Amber Shannon Joiner, MS CCC-SLP
• Anna King, M.S., CCC-SLP
• Mallory Community Health (Dr Arenia C Mallory Community Health Center, Inc)
• Peace Wellness Center LLC
• Mercedes Peeples, PMHNP-BC
• State of Mississippi- University of Mississippi Medical Center
• Courtney Williams

• Nursing Facility/Intermediate Care Facility in Vaiden, MS
• Providers in Vaiden, MS by specialty
• Nursing Facility/Intermediate Care Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.