Ellisville State School
NPI 1720181191 · Health Maintenance Organization · Ellisville, MS
Ellisville State School is a Health Maintenance Organization organization in Ellisville, MS (NPI 1720181191).
Provider details
- NPI number
- 1720181191
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Pam Young, Accounting Auditor 1(601) 477-5606
- License
- 233 (MS)
Specialties & taxonomies
Managed Care Organizations
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Clover Circle Icf/Mr
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2008-06-12
Frequently asked questions
- What is Ellisville State School's NPI number?
- Ellisville State School's National Provider Identifier (NPI) is 1720181191, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ellisville State School?
- Ellisville State School is classified in the NPPES registry as Health Maintenance Organization (Managed Care Organizations).
- Where is Ellisville State School located?
- Ellisville State School's practice location on file with NPPES is 1101 Highway 11 S, Ellisville, MS 39437-4443.
- What is Ellisville State School's phone number?
- The practice phone number listed in the NPPES registry for Ellisville State School is (601) 477-9384.
- Who is the authorized official for Ellisville State School?
- The authorized official listed on Ellisville State School's NPPES record is Pam Young, Accounting Auditor 1. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ellisville State School's NPI active?
- Yes — Ellisville State School's NPI (1720181191) is active in the NPPES registry as of the last update on 2008-06-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.