JACKSON VAMC (NPI# 1154784965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154784965 |
Entity Type | Organization |
Organization Name | JACKSON VAMC |
Other Organization Name | JACKSON VA CARE SITE |
Practice Address |
1500 Woodrow Wilson Ave Jackson MS 39216-5116 |
Mailing Address |
Po Box 94497 Cleveland OH 44101-4497 |
Practice Telephone | 6153553451 |
Mailing Telephone | 6153553451 |
Enumeration Date | 2016-03-30 |
Last Update Date | 2017-10-04 |
Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
Authorized Official Telephone | 2023822579 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
JACKSON VA CARE SITE | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407303050 | Jackson Vamc | Clinic/Center | 6522 Dogwood View Parkway, Suite F, Jackson, MS 39213-7858 | 2016-09-01 |
1841232097 | Jackson Vamc | Clinic/Center | 405 W Adams St, Kosciusko, MS 39090-3617 | 2006-06-12 |
1043250418 | Jackson Vamc | Clinic/Center | 1502 S Colorado St, Greenville, MS 38703-7219 | 2006-06-07 |
1669410288 | Jackson Vamc | Clinic/Center | 2103 13th St, Meridian, MS 39301-4045 | 2006-06-04 |
1528006152 | Jackson Vamc | Clinic/Center | 105 Northgate Rd, Suite 2, Natchez, MS 39120-9162 | 2006-06-04 |
1376598698 | Jackson Vamc | Clinic/Center | 5003 Hardy Street, Tower B Suite 402, Hattiesburg, MS 39402-1331 | 2006-05-24 |
1295787364 | Jackson Vamc | Clinic/Center | 824 Alabama St, Columbus, MS 39702-5436 | 2006-05-17 |
1922496280 | Jackson Vamc | Clinic/Center | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2015-01-08 |
1467762120 | Jackson Vamc | Clinic/Center | 1308 Harrison Ave, Mccomb, MS 39648-2830 | 2010-10-15 |
1992754543 | Jackson Vamc | General Acute Care Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2006-05-10 |
Street Address |
1500 WOODROW WILSON AVE |
City | JACKSON |
State | MS |
Zip Code | 39216-5116 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639272693 | Charles Gerard Sherwood | Ophthalmology | 1500 Woodrow Wilson Ave, G. V. 'sonny' Montgomery Va Medical Center, Jackson, MS 39216 | 2006-09-06 |
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 | 323P00000X |
Grouping | Residential Treatment Facilities |
Classification | Psychiatric Residential Treatment Facility |
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306344478 | Legacy Treatment Serivces, Inc. | Psychiatric Residential Treatment Facility | 417 Smithburg Ct, Jackson, NJ 08527-4444 | 2018-01-24 |
1447462395 | Mississippi Children's Home | Psychiatric Residential Treatment Facility | 1801 N West St, Jackson, MS 39202-1032 | 2007-05-04 |
1467950543 | Community Treatment Solutions | Psychiatric Residential Treatment Facility | 593 Sergey Rd, Jackson, NJ 08527-4705 | 2018-01-24 |
1083112155 | Legacy Treatment Serivces, Inc. | Psychiatric Residential Treatment Facility | 411 Smithburg Ct, Jackson, NJ 08527-4444 | 2018-01-24 |
1699926386 | Woodridge of Tennessee, LLC | Psychiatric Residential Treatment Facility | 49 Old Hickory Blvd, Jackson, TN 38305-4551 | 2008-10-01 |
1639382690 | Cares Center Inc | Psychiatric Residential Treatment Facility | 402 Wesley Ave, Jackson, MS 39202 | 2007-05-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265829584 | Cares Center Inc | Psychiatric Residential Treatment Facility | 28281 Road 401, Saucier, MS 39574-7135 | 2015-04-24 |
1235301615 | Saint Francis Community Services At Mississppi, Inc. | Psychiatric Residential Treatment Facility | 4021 Chicot St, Pascagoula, MS 39581-4327 | 2008-03-26 |
1487762076 | Rehabilitation Centers, LLC | Psychiatric Residential Treatment Facility | 901 First Avenue N.e., Magee, MS 39111 | 2006-08-25 |
1255448775 | Rehabilitation Centers, LLC | Psychiatric Residential Treatment Facility | 1814 Hwy 15 North, Pontotoc, MS 38863 | 2006-08-23 |
1013922954 | Specialized Treatment Facility | Psychiatric Residential Treatment Facility | 14426 James Bond Rd, Gulfport, MS 39503-8311 | 2006-07-29 |
1558504407 | Parkwood Behavioral Health System | Psychiatric Residential Treatment Facility | 8135 Goodman Rd, Olive Branch, MS 38654-2103 | 2009-04-08 |
1467637488 | Specialized Treatment Facility | Psychiatric Residential Treatment Facility | 14426 James Bond Rd, Gulfport, MS 39503-8311 | 2008-01-09 |
1144421496 | Millcreek Schools, LLC | Psychiatric Residential Treatment Facility | 1814 Hwy 15 North, Pontotoc, MS 38863 | 2007-05-31 |
1932232931 | Alliance Health Center, Inc. | Psychiatric Residential Treatment Facility | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2007-03-13 |
1659404572 | Diamond Grove Center | Psychiatric Residential Treatment Facility | 2311 Highway 15 S, Louisville, MS 39339-7071 | 2007-03-13 |
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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.