STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1083041917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083041917 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | UNIVERSITY OF MISSISSIPPI CENTER - GRENADA PSYCH |
| Practice Address |
960 Avent Dr Grenada MS 38901-5230 |
| Mailing Address |
2500 North State Street Jackson MS 39216 |
| Practice Telephone | 6622277000 |
| Mailing Telephone | 6019844113 |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |
| Authorized Official Name | MR. KEVIN COOK (CEO) |
| Authorized Official Telephone | 6019844113 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| University of Mississippi Center - Grenada Psych | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578011417 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 965 Avent Dr Ste 100b, Grenada, MS 38901-5045 | 2016-09-21 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1528495454 | State of Mississippi-university of Mississippi Medical Center | Clinic/Center | 965 Avent Dr Ste 107, Grenada, MS 38901-5045 | 2013-10-10 |
| 1780015396 | State of Mississippi-university of Mississippi Medical Center | Ambulance | 960 J K Avent Dr, Grenada, MS 38901-5230 | 2013-12-06 |
| 1720419583 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1639500499 | State of Mississippi-university of Mississippi Medical Center | Durable Medical Equipment & Medical Supplies | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1831520691 | State of Mississippi-university of Mississippi Medical Center | Nurse Anesthetist, Certified Registered | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1841620846 | State of Mississippi-university of Mississippi Medical Center | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2013-11-13 |
| 1932538527 | State of Mississippi-university of Mississippi Medical Center | Family Medicine | 965 Avent Dr, Suite 100a, Grenada, MS 38901-5045 | 2013-11-05 |
| 1891122727 | State of Mississippi-university of Mississippi Medical Center | Skilled Nursing Facility | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-10-10 |
| Street Address |
960 AVENT DR |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-5230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386644789 | Grenada Lake Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2005-07-28 |
| 1003431602 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-06-10 |
| 1356961320 | Angelina Guilambo | Physical Therapist | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-04-20 |
| 1841822152 | Shelby Helen Phelon Jackson | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-02-05 |
| 1194388082 | Grenada Emergency Group, LLC | Physician Assistant | 960 Avent Dr, Grenada, MS 38901-5230 | 2019-04-17 |
| 1932762721 | Grenada Physician Services, LLC | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2019-04-17 |
| 1013489319 | Kelsey Marter Moncrief | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2018-12-26 |
| 1760908321 | Linda Gail Carter | Nurse Practitioner | 960 Avent Dr, Grenada, MS 38901-5230 | 2017-08-16 |
| 1528463486 | Marionette Yarbrough | Physical Therapist | 960 Avent Dr, Grenada, MS 38901-5230 | 2014-11-04 |
| 1720419583 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487854733 | Ms State Hospital Crisis Intervention Center - Grenada | Psychiatric Hospital | 1970 Grandview Dr, Grenada, MS 38901-5066 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083160782 | Chandra Sumlin-brown Dba Sumlin Behavioral Services | Psychiatric Hospital | 8237b Okatibbee Dam Road, Collinsville, MS 39325 | 2016-09-01 |
| 1588052096 | Charles Harris Phd Pllc | Psychiatric Hospital | 1217 Nelson Dr, Ocean Springs, MS 39564-3032 | 2015-01-06 |
| 1306139928 | Delta Regional Medical Center | Psychiatric Hospital | 300 South Washington Ave., Greenville, MS 38701 | 2011-05-17 |
| 1598943631 | Ms State Hospital Crisis Intervention Center-brookhaven | Psychiatric Hospital | 725 Brookman Dr Ext, Brookhaven, MS 39601-2311 | 2008-01-31 |
| 1568671337 | Three Oaks Behavioral Health of Ridgeland, LLC | Psychiatric Hospital | 408 Fontaine Place, Suite 101, Ridgeland, MS 39157 | 2007-05-21 |
| 1265486492 | Harrison Hma, Inc. | Psychiatric Hospital | 180a Debuys Rd, Biloxi, MS 39531-4402 | 2006-05-20 |
| 1093785859 | Uhs of Parkwood Inc | Psychiatric Hospital | 8135 Goodman Rd, Olive Branch, MS 38654-2103 | 2006-01-25 |
| 1487638441 | Brentwood Acquisition Inc | Psychiatric Hospital | 3531 Lakeland Dr, Flowood, MS 39232-8016 | 2005-12-02 |
| 1063989010 | Oceans Behavioral Hospital of Biloxi LLC | Psychiatric Hospital | 180 Debuys Rd, Biloxi, MS 39531-4402 | 2018-10-29 |
| 1750891792 | Tbd Acquisition II LLC | Psychiatric Hospital | 11150 Highway 49, Gulfport, MS 39503-4110 | 2017-10-04 |
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| 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.