CENTRAL JACKSON FAMILY MEDICAL CLINIC (NPI# 1154549707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154549707 |
| Entity Type | Organization |
| Organization Name | CENTRAL JACKSON FAMILY MEDICAL CLINIC |
| Practice Address |
514 C Woodrow Wilson Jackson MS 39216 |
| Mailing Address |
P.o. Box 4610 Jackson MS 39296-4610 |
| Practice Telephone | 6019817198 |
| Practice Fax Number | 6019816616 |
| Mailing Telephone | 6019817198 |
| Mailing Fax Number | 6019816616 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2010-12-09 |
| Authorized Official Name | DR. CASSANDRA FAYE THOMAS (PHYSICAIN) |
| Authorized Official Telephone | 6019817198 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
18905 | MS | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
13653 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00112137 | 05 | |
| MS | 00937242 | 05 |
| Street Address |
514 C WOODROW WILSON |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750513818 | Magnolia Addiction Treatment Services | Clinic/Center | 500 E Woodrow Wilson Ave Ste D, Jackson, MS 39216-4538 | 2009-08-21 |
| 1831437078 | James T Craig Jr Md Inc | Clinic/Center | 1004 Greystone Sq, Jackson, TN 38305-3580 | 2013-01-23 |
| 1407136708 | Therapy Staff Solutions | Clinic/Center | 1311 W Pearl St, Jackson, MS 39203-2841 | 2011-08-18 |
| 1710280557 | Cassandra F Thomas | Clinic/Center | 514c E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2010-12-17 |
| 1194044750 | Teton Dermatology Inc | Clinic/Center | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2010-05-21 |
| 1053554162 | Double Rainbow Sciences, LLC | Clinic/Center | 555 E. Broadway, Suite 108, Jackson, WY 83001 | 2009-04-20 |
| 1235318874 | Dermatology Associates LLC | Clinic/Center | 501 Marshall St Ste 606, Jackson, MS 39202-1650 | 2007-10-31 |
| 1992998124 | Farmer and Associates Internal Medicine | Clinic/Center | 1860 Chadwick Dr, Suite 303, Jackson, MS 39204-3463 | 2007-08-21 |
| 1821291543 | West Tennessee Kidney Specialists P.C. | Clinic/Center | 221 Sterling Farms Drive, Jackson, TN 38305-3609 | 2007-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029249 | Ortho Express Holding Company, LLC | Clinic/Center | 608 W Church St, Booneville, MS 38829 | 2020-07-02 |
| 1841646148 | Hooks Diabetes & Medicine Clinic, Pllc | Clinic/Center | 2625 Traceland Dr Ste A, Tupelo, MS 38801-4240 | 2016-05-05 |
| 1194060350 | Stewart Ear Sinus & Allergy Pllc | Clinic/Center | 4 Professional Plaza, Starkville, MS 39759 | 2012-11-29 |
| 1912200460 | Amory Hma Physician Mgmt LLC | Clinic/Center | 607 Earl Frye Blvd # A, Amory, MS 38821-5503 | 2010-12-06 |
| 1205146719 | Voulters Medical Consulting | Clinic/Center | 927 E Scenic Dr, Pass Christian, MS 39571-4701 | 2010-10-18 |
| 1629393491 | Soma Plastic Surgery and Hand Clinic | Clinic/Center | 2630 Courthouse Cir Ste A, Flowood, MS 39232-9562 | 2010-04-05 |
| 1598911877 | George E. Wilkerson, M.d., P.a. | Clinic/Center | 348 Crossgates Blvd Ste 2300, Brandon, MS 39042-2634 | 2008-08-18 |
| 1174798334 | Don S Davis Md Pa | Clinic/Center | 5002 Hwy 39 N Bldg A, Meridian, MS 39301-1078 | 2008-04-28 |
| 1346424819 | North Mississippi Vascular Center, Pa | Clinic/Center | 1040a S Madison St, Tupelo, MS 38801-6300 | 2007-12-19 |
| 1124201892 | Rome Sherrod II Md | Clinic/Center | 7600 Airways Blvd Ste B, Southaven, MS 38671-5138 | 2007-12-17 |
| Find all providers with the same taxonomy | ||||
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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.