North Street Healthcare LLC
NPI 1568791804ActiveOrganization· Skilled Nursing Facility· Jackson, MS
Skilled Nursing Facility in Jackson, Mississippi, registered in NPPES in December 2009. The authorized official on file is Charles Bruce Kelly, Managing Member. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1568791804 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 16, 2009 |
| Last updated in NPPES | Dec 16, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | APPLING FOR | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (MS) |
|---|
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