Bedford Alzheimers Care Center, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

1008 Issued in MS

Legal business name

BEDFORD ALZHEIMERS CARE CENTER, LLC

Practice address

300 Cahal St
Suite B
Hattiesburg, MS 39401-2922

Phone

(601) 582-9157

Fax

(601) 582-2639

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jack A Bevon, III

Title

Administrator

Phone

(601) 582-9157

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Peter Hand, M.D.

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1689664039
  NPD (past)
• Omolara Otaigbe, MD

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1932164456
  NPD (past)

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1831371210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CAHAL ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394012922",
            "telephone_number": "601-582-9157",
            "fax_number": "601-582-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CAHAL ST",
            "address_2": "SUITE B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394012922",
            "telephone_number": "601-582-9157",
            "fax_number": "601-582-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD ALZHEIMERS CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "BEVON, III",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-582-9157",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MS",
            "license": "1008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00232558",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annie Beaugh, DPT
• Jennifer Beckham, PHARMD
• Lauren Brewer Beckman, AGPCNP
• Becoming Undone Therapy Services LLC
• Jeremy Brooks Becton, MD
• Bedford Care Center of Hattiesburg, LLC
• Bedford Care Center-Monroe Hall, LLC
• Steffany Bedwell, NP
• Behavioral Healthcare Center LLC
• Charles Lindsey Belknap, DMD

• Alzheimer Center (Dementia Center) in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Alzheimer Center (Dementia Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.