NPIMap

Organization Active NPI

Emeritrace LLC

  • Assisted Living Facility
  • Clinton, MS
National Provider Identifier
1932909421
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EMERITRACE LLC
Practice address
501 E Northside Dr
Clinton, MS 39056-3604
Phone
(601) 926-1224
NPI assigned
Mar 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Anna F.C. Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

501 E Northside Dr
Clinton, MS 39056-3604

Mailing address

501 E Northside Dr
Clinton, MS 39056-3604
Phone (601) 926-1224

Other names 1

  • Brookdale Clinton Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2194037Brookdale Clinton Assisted Living and Memory Care501 E Northside Dr, Clinton, MS 39056Certificate of waiverSep 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
Summerville at St Augustine LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1932909421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E NORTHSIDE DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563604",
            "telephone_number": "601-926-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E NORTHSIDE DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563604",
            "telephone_number": "601-926-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERITRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Clinton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.