MISSISSIPPI STATE HOSPITAL AT WHITFIELD (NPI# 1336224179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336224179 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI STATE HOSPITAL AT WHITFIELD |
| Other Organization Name | MISSISSIPPI STATE HOSPITAL COMMUNITY SERVICES MENTAL HEALTH |
| Practice Address |
350 Capers Avenue Jackson MS 39203 |
| Mailing Address |
P.o. Box 1 - Fiscal Services 3550 Highway 468 West Whitfield MS 39193-0157 |
| Practice Telephone | 6013518000 |
| Practice Fax Number | 6013518301 |
| Mailing Telephone | 6013518000 |
| Mailing Fax Number | 6013518301 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-03-14 |
| Authorized Official Name | MR. JAMES G CHASTAIN (DIRECTOR) |
| Authorized Official Telephone | 6013518000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MISSISSIPPI STATE HOSPITAL AT WHITFIELD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | DCS-MSH | MS | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04972797 | 05 |
| Other Name | Type Code |
|---|---|
| Mississippi State Hospital Community Services Mental Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497788715 | Mississippi State Hospital At Whitfield | Psychiatry & Neurology | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-07-09 |
| 1467573543 | Mississippi State Hospital At Whitfield | Psychiatric Hospital | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2007-04-03 |
| 1598841702 | Mississippi State Hospital At Whitfield | Pharmacy | 3550 Highway 468 W, Whitfield, MS 39193-5529 | 2006-10-31 |
| 1568557320 | Mississippi State Hospital At Whitfield | Dentist | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-10-04 |
| 1477648236 | Mississippi State Hospital At Whitfield | Psychiatric Hospital | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-10-04 |
| 1396830147 | Mississippi State Hospital At Whitfield | General Acute Care Hospital | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-10-04 |
| 1053335497 | Mississippi State Hospital At Whitfield | Psychiatry & Neurology | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-07-27 |
| 1982620712 | Mississippi State Hospital At Whitfield | General Practice | 3550 Hwy 468 West, Whitfield, MS 39193-0157 | 2006-07-14 |
| Street Address |
350 CAPERS AVENUE |
| City | JACKSON |
| State | MS |
| Zip Code | 39203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743162 | Shymeka Bolden | Home Health | 405 Dewitt Ave, Jackson, MS 39203 | 2020-09-08 |
| 1083027544 | Debra Williams | Counselor | 514 West Fortification Ave, Jackson, MS 39203 | 2014-06-03 |
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1710022959 | Jackson Public Schools Dba Galloway Clinic | Registered Nurse | 186 Idlewild St, Jackson, MS 39203-1219 | 2007-02-21 |
| 1457522260 | Jimmie C Robinson | Durable Medical Equipment & Medical Supplies | 605 W Fortification St, Jackson, MS 39203-1706 | 2008-03-19 |
| 1093277428 | Connections Counseling & Consulting LLC | Social Worker | 338 Oak St, Jackson, MS 39203-1810 | 2019-04-04 |
| 1033504816 | Niesha Lasha Gilmore | Occupational Therapist | 519 Scott St, Jackson, MS 39203-1825 | 2015-03-30 |
| 1255952453 | Innovative Hands of Therapy Services LLC | Occupational Therapist | 519 Scott St, Jackson, MS 39203-1825 | 2020-04-29 |
| 1588812341 | Deepti Amol Janorkar | Dentist | 275 Roseneath Ave, Jackson, MS 39203-2052 | 2008-09-05 |
| 1558637207 | Anna Leigh Lovett | Family Medicine | 275 Roseneath Ave, Jackson, MS 39203-2052 | 2012-03-27 |
| Find all providers in zip 39203 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285134965 | Guardian Angel Homes LLC | Community Based Residential Treatment Facility, Mental Illness | 1038 Woodbridge St, Jackson, MI 49203-3112 | 2018-02-19 |
| 1821537259 | Open Arms | Community Based Residential Treatment Facility, Mental Illness | 2907 Glenderry St, Jackson, MS 39212-2722 | 2017-02-17 |
| 1316360449 | Middle Ms Access Corporation | Community Based Residential Treatment Facility, Mental Illness | 620 W Amite St, Jackson, MS 39203-2618 | 2014-01-24 |
| 1780873232 | Mississippi Children's Home Society - Mypac | Community Based Residential Treatment Facility, Mental Illness | 1900 N West St, Jackson, MS 39202-1033 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833575 | Embracing Hearts Healthcare | Community Based Residential Treatment Facility, Mental Illness | 1018 Emileigh Dr, Summit, MS 39666-4700 | 2020-08-25 |
| 1285157693 | Schylon Smith | Community Based Residential Treatment Facility, Mental Illness | 535 Holt Collier St, Greenville, MS 38701-3846 | 2017-07-18 |
| 1467646034 | Baptist Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 461 Goodloe Rd, Canton, MS 39046 | 2007-08-28 |
| 1003243965 | Region Iv | Community Based Residential Treatment Facility, Mental Illness | 120 Randy Hendrix Dr, Batesville, MS 38606-7664 | 2013-10-08 |
| 1588091458 | Region Iv Mental Health Services | Community Based Residential Treatment Facility, Mental Illness | 120 Randy Hendrix Dr, Batesville, MS 38606-7664 | 2013-10-08 |
| 1922262708 | Central Mississippi Residential Center | Community Based Residential Treatment Facility, Mental Illness | 701 Northside Drive, Newton, MS 39345-0470 | 2008-07-11 |
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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.