MISSISSIPPI BAPTIST MEDICAL CENTER, INC. (NPI# 1417984360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417984360 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI BAPTIST MEDICAL CENTER, INC. |
| Other Organization Name | MS BAPITST MEDICAL CENTER GERI-PSYCH UNIT |
| Practice Address |
1225 N State St Jackson MS 39202-2064 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 6019685130 |
| Practice Fax Number | 6019681383 |
| Mailing Telephone | 9012275233 |
| Enumeration Date | 2006-06-27 |
| 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 |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 14-281 | MS | Hospital Units |
| Other Name | Type Code |
|---|---|
| MS Bapitst Medical Center Geri-Psych Unit | Doing Business As Name - 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 |
| 1255882890 | Mississippi Baptist Medical Center, Inc. | Pharmacy | 1225 N State St, Jackson, MS 39202-2064 | 2016-10-19 |
| 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 |
| 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 |
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| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962594317 | W.a. Foote Memorial Hospital, Inc. | Psychiatric Unit | 205 N East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| 1679596860 | St Dominic-jackson Memorial Hospital | Psychiatric Unit | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2006-07-26 |
| 1912945775 | Jackson Hma LLC | Psychiatric Unit | 1850 Chadwick Dr, Jackson, MS 39204-3404 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407269756 | East Mississippi State Hospital | Psychiatric Unit | 1401 College Dr, Meridian, MS 39307-5345 | 2014-06-04 |
| 1699803395 | Walter Robert Jones Jr. | Psychiatric Unit | Hwy 468, Hudspeth Regional Center, Whitfield, MS 39193 | 2007-03-02 |
| 1740228881 | Vicksburg Healthcare LLC | Psychiatric Unit | 1111 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-02 |
| 1306803481 | George County Hospital | Psychiatric Unit | 859 Winter Steet, Lucedale, MS 39452-6603 | 2006-05-01 |
| 1457330995 | South Mississippi State Hospital | Psychiatric Unit | 823 Highway 589, Purvis, MS 39475-4194 | 2006-01-12 |
| 1831184951 | Alliance Health Center Inc | Psychiatric Unit | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2005-09-14 |
| 1801414115 | Singing River Gulfport | Psychiatric Unit | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-07-13 |
| 1679036313 | Progressive Medical Management of Batesville LLC | Psychiatric Unit | 155 Keating Rd, Batesville, MS 38606-2901 | 2019-04-10 |
| 1689191629 | Boa Vida Hospital of Aberdeen, Ms, LLC | Psychiatric Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-08-29 |
| 1033643937 | Batesville Regional Medical Center, Inc. | Psychiatric Unit | 303 Medical Center Dr, Batesville, MS 38606-8608 | 2017-04-18 |
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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.