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North Street Healthcare LLC

Skilled Nursing Facility in Jackson, MS · enumerated 2009 · authorized official Charles Kelly, Managing Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568791804

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Registry record

Entity type Organization (Type 2)
Legal business name North Street Healthcare LLC
Other name <Unavail>
Practice address 865 North St, Jackson, MS, 39202
Phone (601) 948-6531
Fax (601) 948-6166
Enumeration date Dec 16, 2009
Last updated in NPPES Dec 16, 2009

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License APPLING FOR (MS) Primary

Authorized official

Name Charles Kelly
Title Managing Member
Phone (601) 304-0980

Other identifiers

Identifier Type State Issuer
00230016 Medicaid MS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for North Street Healthcare LLC?
The NPI for North Street Healthcare LLC is 1568791804, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for North Street Healthcare LLC?
NPPES lists Charles Kelly (Managing Member) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-12-16.