STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1285126029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285126029 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | MIDTOWN MOBILE CLINIC |
| Practice Address |
258 E Fortification St Jackson MS 39202-2356 |
| Mailing Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6018158230 |
| Mailing Telephone | 6019846270 |
| Mailing Fax Number | 6018154119 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | MR. JEFFREY GRIMSLEY (INTERIM CFO) |
| Authorized Official Telephone | 6018158732 |
| 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 | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Midtown Mobile Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841727971 | State of Mississippi- University of Mississippi Medical Center | Clinic/Center | 201a Magnolia St, Vaiden, MS 39176-5644 | 2017-05-19 |
| 1689810327 | State of Mississippi- University of Mississippi Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2008-12-31 |
| 1194930693 | State of Mississippi- University of Mississippi Medical Center | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 479, Jackson, MS 39213-7681 | 2007-05-10 |
| Street Address |
258 E FORTIFICATION ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023077765 | Barbara Janet Boss | Nurse Practitioner | 258 E Fortification St, Jackson, MS 39202-2356 | 2006-03-21 |
| 1649573783 | Sherrikee Causey | Nurse Practitioner | 258 E Fortification St, Jackson, MS 39202-2356 | 2010-12-13 |
| 1588624621 | Pamela Helms | Nurse Practitioner | 258 E Fortification St, Jackson, MS 39202-2356 | 2006-03-24 |
| 1861451510 | Audwin Fletcher | Nurse Practitioner | 258 E Fortification St, Jackson, MS 39202-2356 | 2006-03-21 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972150084 | Wound Management Specialists, LLC | Clinic/Center | 1190 N State St Ste 2a, Jackson, MS 39202-2413 | 2019-08-22 |
| 1700449329 | Cycle 8 Health Care, LLC | Clinic/Center | 2310 Highway 80 W Ste 2260, Jackson, MS 39204-2383 | 2019-04-18 |
| 1093286544 | East Endocrine and Metabolism Pllc | Clinic/Center | 3829 Greentree Pl, Jackson, MS 39211-6737 | 2018-12-10 |
| 1760965206 | Hunter Assets Holding LLC | Clinic/Center | 1035 W Mayes St, Jackson, MS 39213-6100 | 2018-09-11 |
| 1235634759 | W A Foote Memorial Hospital Inc | Clinic/Center | 2200 Springport Rd Ste 230, Jackson, MI 49202-1432 | 2018-03-27 |
| 1336644897 | W A Foote Memorial Hospital Inc | Clinic/Center | 3305 Spring Arbor Rd Ste 500, Jackson, MI 49203-3795 | 2018-03-27 |
| 1730684580 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 210, Jackson, MI 49202-1432 | 2018-03-26 |
| 1164927844 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 800, Jackson, MI 49202-1432 | 2018-03-26 |
| 1225532120 | Robert Greer Do, LLC | Clinic/Center | 5345 Farnsworth Dr, Jackson, MS 39211-4604 | 2018-03-23 |
| 1447761713 | Celestial Health Creations | Clinic/Center | 7 Lakeland Cir Ste 300, Jackson, MS 39216-5022 | 2017-10-13 |
| 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.