1. Home
  2. Directory
  3. Mississippi
  4. West Point
  5. Nursing Facility Intermediate Care Facility
  6. NPI Profile

HEAVENLY ANGELS LLC
NPI 1700367174
Nursing Facility/Intermediate Care Facility in West Point, MS

Active since August 23, 2018CLIA 25D2234002 · Waiver
1333 E BROAD ST, WEST POINT, MS 39773(662) 295-3257 Get Directions Write a Review

NPPES record last updated: October 11, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 11, 2022, Sep 11, 2022, Apr 24, 2022 and 3 more (6 updates tracked since 2018).

About Heavenly Angels Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEAVENLY ANGELS LLC (NPI 1700367174) is a healthcare organization registered as a nursing facility/intermediate care facility in West Point, Mississippi and active in the NPI registry since August 2018. The organization holds a CLIA Waiver certificate valid through August 26, 2027 and lists Angela Rice, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1700367174
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameHEAVENLY ANGELS LLC
Location Address1333 E BROAD STWest Point, MS 39773-3180
Mailing Address1333 E Broad StWest Point, MS 39773-3180 · (662) 295-3257
Phone(662) 295-3257
Organization SubpartNo
Authorized OfficialAngela RiceExecutive Director · (662) 295-3257
Enumeration DateAugust 23, 2018
Last NPPES UpdateOctober 11, 20226 updates tracked since enumeration
NPPES CertifiedOctober 11, 2022
✔ NPI 1700367174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedHome HealthTaxonomy 251E00000X
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
Also ListedAssisted Living FacilityTaxonomy 310400000X
Also ListedAssisted Living Facility · Assisted Living, Mental IllnessTaxonomy 3104A0625X
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X
Also ListedCommunity Based Residential Treatment Facility, Mental IllnessTaxonomy 320800000X
Also ListedRespite CareTaxonomy 385H00000X
1333 E BROAD ST, West Point, MS 39773
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heavenly Angels Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Heavenly Angels LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Tiffany Warren, FNP
Nurse Practitioner
NPI 1932551520
255 BAPTIST BLVD
Columbus, MS 39705
(662) 256-9331
✔ PECOS✔ Accepts Medicare15 mi
Thelma Cox Shelton, FNP-BC
Nurse Practitioner
NPI 1700458122
114 N HICKORY ST STE C
Aberdeen, MS 39730
(662) 813-5051
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2234002

Heavenly Angels LLC · West Point, MS
Active · expires Aug 26, 2027
CLIA Number25D2234002
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 27, 2025
Certificate Expiration DateAugust 26, 2027
Laboratory DirectorAngela Rice
Laboratory Phone(662) 295-3257
Laboratory LocationHeavenly Angels LLC1333 East Broad St, West Point, MS 39773
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heavenly Angels LLC's NPI number?

The NPI number for Heavenly Angels LLC is 1700367174. It was assigned to this organization in the NPPES registry on August 23, 2018.

Where is Heavenly Angels LLC located?

Heavenly Angels LLC is located at 1333 E Broad St, West Point, MS 39773. The listed phone number is (662) 295-3257.

What is Heavenly Angels LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Is Heavenly Angels LLC enrolled in Medicare?

Yes. Heavenly Angels LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Heavenly Angels LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Heavenly Angels LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Heavenly Angels LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2234002) is associated with this NPI, valid through August 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Heavenly Angels LLC was last updated on October 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.