PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC (NPI# 1053483735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053483735 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC |
| Practice Address |
501 Marshall St Suite 201 Jackson MS 39202-1651 |
| Mailing Address |
864 Wilson Dr Suite C Ridgeland MS 39157-4512 |
| Practice Telephone | 6013522273 |
| Practice Fax Number | 6013534414 |
| Mailing Telephone | 6012066100 |
| Mailing Fax Number | 6012066052 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2011-09-16 |
| Authorized Official Name | DONNA LAY (DIRECTOR OF PATIENT'S ACCOUNTS) |
| Authorized Official Telephone | 6013522273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00770341 | 05 | |
| MS | RAILROAD MEDICARE | 490004328 | 01 |
| Street Address |
501 MARSHALL ST SUITE 201 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932176641 | Sabra Sullivan | Dermatology | 501 Marshall St, Suite 606, Jackson, MS 39202-1651 | 2006-03-01 |
| 1598328684 | Caroline Douglass Peeples | Registered Nurse | 501 Marshall St, Jackson, MS 39202-1651 | 2019-04-15 |
| 1548655053 | Mississippi Urology Outpatient Surgery Center, LLC | Clinic/Center | 501 Marshall St, Suite 201, Jackson, MS 39202-1651 | 2015-04-01 |
| 1639586076 | Baptist Heart | Internal Medicine | 501 Marshall St, Suite 104, Jackson, MS 39202-1651 | 2014-07-17 |
| 1568709574 | Medical Foundation of Central Ms | Surgery | 501 Marshall St, Suite 500, Jackson, MS 39202-1651 | 2013-01-10 |
| 1417291451 | Urogyn Diagnostics LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-11-15 |
| 1548513617 | Southeast Urogyn LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-10-26 |
| 1477825800 | The Medical Foundation of Central Mississippi | Clinic/Center | 501 Marshall St, Suite 100, Jackson, MS 39202-1651 | 2012-02-01 |
| 1265712145 | Laurie Selman Nimon | Nurse Practitioner | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2011-08-23 |
| 1992034771 | Southeast Urogynecology Pa | Urology | 501 Marshall St, Suite 607-a, Jackson, MS 39202-1651 | 2009-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780776138 | W.a. Foote Memorial Hospital, Inc. | Clinic/Center | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| 1255883690 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jmm Suite 2525, Jackson, MS 39216-4500 | 2016-11-02 |
| 1356686349 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 4400 Ann Arbor Rd, Jackson, MI 49202-2814 | 2012-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558553859 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 106 Highland Way Ste 101, Madison, MS 39110-6930 | 2007-08-10 |
| 1740264274 | Magnolia Endoscopy Center, LLC | Clinic/Center | 3050 Corder Dr, Corinth, MS 38834-6210 | 2005-11-29 |
| 1932537750 | Digestive Health Endoscopy Asc LLC | Clinic/Center | 90 Industrial Park Cir, Ocean Springs, MS 39564-5800 | 2013-10-15 |
| 1366634669 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 1815 Mission 66, Vicksburg, MS 39180-3709 | 2007-08-10 |
| 1245352327 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 2510 Lakeland Dr, Flowood, MS 39232-9513 | 2007-04-06 |
| 1598879009 | Digestive Diseases Center of Hattiesburg, LLC | Clinic/Center | 100 Methodist Hospital Blvd, Hattiesburg, MS 39402-1295 | 2006-08-19 |
Please comment or provide details below to improve the information on PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.