CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC (NPI# 1134592777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134592777 |
Entity Type | Organization |
Organization Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC |
Other Organization Name | PECAN PARK ELEMENTARY SCHOOL-BASED |
Practice Address |
415 Claiborne Ave Jackson MS 39209-5321 |
Mailing Address |
3502 W Northside Dr Jackson MS 39213-4454 |
Practice Telephone | 6013645142 |
Enumeration Date | 2015-11-04 |
Last Update Date | 2015-11-04 |
Authorized Official Name | JASMIN CHAPMAN (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 6013645142 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Pecan Park Elementary School-Based | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689047292 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3930 Skyview Dr, Jackson, MS 39213-5318 | 2015-11-04 |
1205021946 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 327 S Gallatin St, Jackson, MS 39203-3514 | 2007-09-06 |
1700813052 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 129 White Oak St, Utica, MS 39175-8803 | 2006-06-26 |
1932145539 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 1203 Mission Park Dr, Vicksburg, MS 39180-3747 | 2006-06-21 |
1760420335 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 550 Caldwell Dr, Hazlehurst, MS 39083-2304 | 2006-06-03 |
1811425291 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 7255 Gary Rd, Byram, MS 39272-8947 | 2017-05-30 |
1689047201 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 386 Raymond Rd, Jackson, MS 39204-3700 | 2015-11-04 |
1548342611 | Central Mississippi Civic Improvement Association, Inc | Pharmacy | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-10-19 |
1134151442 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
1972535250 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
Street Address |
415 CLAIBORNE AVE |
City | JACKSON |
State | MS |
Zip Code | 39209-5321 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
Find all providers in zip 39209 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689047292 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3930 Skyview Dr, Jackson, MS 39213-5318 | 2015-11-04 |
1588088025 | Southside Medical Center, Inc. | Clinic/Center | 176 Lyons St, Jackson, GA 30233-2134 | 2014-02-04 |
1326328311 | Rural Health Services, Inc. | Clinic/Center | 210 Atomic Rd, Jackson, SC 29831-3409 | 2011-08-22 |
1427377266 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 350 Woodrow Wilson Blvd, Jackson, MS 39213-4454 | 2010-05-19 |
1376732313 | Central Mississippi Civic Improvement Association | Clinic/Center | 1716 Isable St, Jackson, MS 39204-2352 | 2007-10-16 |
1447448667 | Central Mississippi Civic Improvement Association | Clinic/Center | 2185 Fortune St, Jackson, MS 39204-2333 | 2007-10-12 |
1205021946 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 327 S Gallatin St, Jackson, MS 39203-3514 | 2007-09-06 |
1598893547 | Rural Health Group, Inc. | Clinic/Center | 9409 Nc Hwy 305, Jackson, NC 27845-0594 | 2007-03-01 |
1023100955 | Community Action Committee of Pike County | Clinic/Center | 14590 State Route 93, Jackson, OH 45640-8977 | 2006-09-28 |
1255360483 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 1655 Whiting Rd, Jackson, MS 39209-5826 | 2006-07-01 |
Find all providers in JACKSON |
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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.