Beverly C Johnson, MSW

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

MS68NHC Issued in MS

Practice address

116 S Edward Avenue
Mound Bayou, MS 38762

Phone

(662) 719-2005

NPI assigned

Jul 19, 2013

Last updated

Jul 19, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Nevaeh Hospice

  dba Nevaeh Home Maker Service

  • In Home Supportive Care Agency
  • Mound Bayou, MS
  • NPI 1639890957
  NPD Authorized official
• Community Adult Day Care

  • Adult Day Care Clinic/Center
  • Mound Bayou, MS
  • NPI 1629310487
  Authorized official Same address or phone
• Dignity Hospice LLC

  dba Dignity Hospice

  • Community Based Hospice Care Agency
  • Brookhaven, MS
  • NPI 1548690365

  Hospice Care, Community Based

  NPD (past)

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1891137873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 EDWARD AVENUE",
            "address_2": "SUITE B",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "38762",
            "telephone_number": "662-719-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S EDWARD AVENUE",
            "city": "MOUND BAYOU",
            "state": "MS",
            "postal_code": "38762",
            "telephone_number": "662-719-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEVERLY",
        "middle_name": "C",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "MS68NHC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rotonia Gates, LPN
• Candace L. Gillespie, ED. D., NCC, LPC
• Laura Grant
• Shaunde Gray, MHA, COTA, LIA
• Home of Care Personal Care Services
• Carol Mack, LCSW
• Making Moves in the Community, Incorporated
• Drahea Martin, DDS
• Cordaro Mays, NREMT-P, ASCP
• Simone Shardae Williams Moore, MD

• Community Based Hospice Care Agency in Mound Bayou, MS
• Providers in Mound Bayou, 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 Jul 19, 2013; 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.