NPIMap

Organization Active NPI

Jasper County Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Bay Springs, MS
National Provider Identifier
1992804512
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
209 Issued in MS
Legal business name
JASPER COUNTY NURSING HOME
Practice address
15A South 6TH Street
Bay Springs, MS 39422
Phone
(601) 764-2101
Fax
(601) 764-2930
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Marshall Kenneth Posey
Title
Administrator
Phone
(601) 764-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 209 MS Primary

Addresses

Primary practice location

15A South 6TH Street
Bay Springs, MS 39422

Mailing address

PO Box 527
Bay Springs, MS 39422-0527
Phone (601) 764-2101

Other identifiers 1

IdentifierTypeStateIssuer
00023083MedicaidMS

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
25D2140994Jasper County Nursing Home15 South 6TH Street, Bay Springs, MS 39422Certificate of waiverDec 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Jasper General Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992804512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394220527",
            "telephone_number": "601-764-2101",
            "fax_number": "601-764-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15A SOUTH 6TH STREET",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "39422",
            "telephone_number": "601-764-2101",
            "fax_number": "601-764-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POSEY",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-764-2101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MS",
            "license": "209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00023083",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.