MISSISSIPPI BAPTIST MEDICAL CENTER, INC. (NPI# 1609485440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609485440 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI BAPTIST MEDICAL CENTER, INC. |
| Other Organization Name | MBMC REFERENCE LABORATORY |
| Practice Address |
1225 N State St Jackson MS 39202-2064 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 6019683070 |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | MR. 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 | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| MBMC Reference Laboratory | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 1790240174 | Kruti Prakash Patel | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-02-09 |
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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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922616168 | Quest Diagnostics | Clinical Medical Laboratory | 14590 State Route 93 Ste A, Jackson, OH 45640-8977 | 2020-07-14 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1134699945 | Executive Diagnostics LLC | Clinical Medical Laboratory | 5455 Executive Pl Ste B, Jackson, MS 39206-4104 | 2018-12-05 |
| 1174028856 | W. A. Foote Memorial Hospital, Inc. | Clinical Medical Laboratory | 1100 E Michigan Ave Ste 104, Jackson, MI 49201-1800 | 2018-03-26 |
| 1649775495 | W. A. Foote Memorial Hospital, Inc. | Clinical Medical Laboratory | 1201 E Michigan Ave Ste 115, Jackson, MI 49201-1852 | 2018-03-26 |
| 1881064772 | Apple Pharmaceuticals & Healthcare Services, LLC | Clinical Medical Laboratory | 115 Riley Dr, Jackson, MS 39209-2595 | 2015-10-05 |
| 1508069824 | Transsouth Health Care PC | Clinical Medical Laboratory | 14 Weatherford Sq, Jackson, TN 38305 | 2007-06-06 |
| 1316084015 | Medical Genetics Lab | Clinical Medical Laboratory | 2500 N State St Dept Cgen, Room R622, Jackson, MS 39216-4500 | 2007-01-31 |
| 1356374912 | Dermatopathology Associates, Pllc | Clinical Medical Laboratory | 3120 Old Canton Rd, Jackson, MS 39216 | 2006-07-08 |
| 1760469076 | Garcia Clinical Laboratory Inc | Clinical Medical Laboratory | 2195 Spring Arbor Rd, Jackson, MI 49203-2797 | 2005-12-28 |
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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.