MISSISSIPPI BAPTIST MEDICAL CENTER, INC. (NPI# 1255882890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255882890 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI BAPTIST MEDICAL CENTER, INC. |
| Other Organization Name | BAPTIST FAMILY PHARMACY |
| Practice Address |
1225 N State St Jackson MS 39202-2064 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 6019686350 |
| Practice Fax Number | 6019686351 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | GREGORY M DUCKETT (SR VP/ CLO) |
| Authorized Official Telephone | 9012275233 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAPTIST MEMORIAL HEALTH CARE CORP. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
15022/1.1 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00031730 | 05 |
| Other Name | Type Code |
|---|---|
| Baptist Family Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609485440 | Mississippi Baptist Medical Center, Inc. | Clinical Medical Laboratory | 1225 N State St, Jackson, MS 39202-2064 | 2020-07-28 |
| 1730480120 | Mississippi Baptist Medical Center, Inc. | General Acute Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2010-11-16 |
| 1528289592 | Mississippi Baptist Medical Center, Inc. | General Acute Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2007-05-01 |
| 1124155809 | Mississippi Baptist Medical Center, Inc. | Nurse Anesthetist, Certified Registered | 1225 N State St, Jackson, MS 39202-2064 | 2007-02-28 |
| 1467589556 | Mississippi Baptist Medical Center, Inc. | Psychiatry & Neurology | 1225 N State St, Jackson, MS 39202-2064 | 2007-02-27 |
| 1710909585 | Mississippi Baptist Medical Center, Inc. | General Acute Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2006-07-24 |
| 1417984360 | Mississippi Baptist Medical Center, Inc. | Psychiatric Unit | 1225 N State St, Jackson, MS 39202-2064 | 2006-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MISSISSIPPI BAPTIST MEDICAL CENTER, INC. | 1225 N State St, Jackson, MS 39202-2064 |
| Street Address |
1225 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919216 | Richard B Friedman | Radiology | 1225 N State St, Jackson, MS 39202-2064 | 2005-06-01 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1861009714 | April Stevenson Corcoran | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2020-09-24 |
| 1609485440 | Mississippi Baptist Medical Center, Inc. | Clinical Medical Laboratory | 1225 N State St, Jackson, MS 39202-2064 | 2020-07-28 |
| 1912530569 | Brandi Burge Wagner | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2020-02-21 |
| 1760028955 | Erin Jones | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-21 |
| 1780229641 | Lauren Blakeney | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-14 |
| 1417591322 | Lou Ann Wells | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-04 |
| 1861043531 | Jessica Candace Cody | Anesthesiology | 1225 N State St, Jackson, MS 39202-2064 | 2019-09-24 |
| 1386290955 | Brady K Lowery | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-08-10 |
| 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 | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144874868 | Whitney Harris Drugs, Inc. | Pharmacy | 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 | 2019-07-31 |
| 1013576826 | Avita Drugs Mississippi, LLC | Pharmacy | 805 E River Pl Ste A, Jackson, MS 39202-3486 | 2019-06-06 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| 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.