MALL SERVICES, LLC (NPI# 1699005983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699005983 |
| Entity Type | Organization |
| Organization Name | MALL SERVICES, LLC |
| Other Organization Name | THE VILLAGE CLINIC |
| Practice Address |
386 Raymond Rd Building 30 Jackson MS 39204-3700 |
| Mailing Address |
350 W Woodrow Wilson Ave Suite 615 Jackson MS 39213-7681 |
| Practice Telephone | 6019820673 |
| Practice Fax Number | 6019820459 |
| Mailing Telephone | 6019820673 |
| Mailing Fax Number | 6019820459 |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2010-01-08 |
| Authorized Official Name | MRS. CHRISTAL ROGERS (CLINIC MANAGER) |
| Authorized Official Telephone | 6019520673 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04135059 | 05 | |
| MS | 00122194 | 05 | |
| MS | 00122254 | 05 |
| Other Name | Type Code |
|---|---|
| THE VILLAGE CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1841456472 | Mall Services, LLC | Clinic/Center | 1066 Wiggins Road, Jackson, MS 39209 | 2008-08-04 |
| 1548539117 | Mall Services, LLC | Clinic/Center | 1860 Chadwick Dr, Suite 305, Jackson, MS 39204-3463 | 2011-12-27 |
| 1245477165 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2009-01-14 |
| 1063659340 | Mall Services, LLC | Community Health Worker | 809 N State St, Jackson, MS 39202-2604 | 2009-01-08 |
| 1881878577 | Mall Services, LLC | Clinic/Center | 833 Maple St, Jackson, MS 39203-3844 | 2007-12-18 |
| 1285700617 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2006-11-28 |
| Street Address |
386 RAYMOND RD BUILDING 30 |
| City | JACKSON |
| State | MS |
| Zip Code | 39204-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689047201 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 386 Raymond Rd, Jackson, MS 39204-3700 | 2015-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1003470758 | Central Mississippi Health Services, Inc | Family Medicine | 3450 Highway 80 W Ste 71, Jackson, MS 39209-7201 | 2019-04-29 |
| 1922515493 | Meaghan Schenk Johnson | Family Medicine | 2969 Curran Dr N # 200, Jackson, MS 39216-4121 | 2018-01-05 |
| 1740795731 | Emily Colleen Dunaway | Family Medicine | 1227 N State St # 101, Jackson, MS 39202-2002 | 2017-12-12 |
| 1679086367 | Hope Np House Call Practice | Family Medicine | 98 Grandview Ave, Jackson, OH 45640-9090 | 2017-11-16 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1891235289 | Logan Hardin | Family Medicine | 1270 Union University Dr Ste A, Jackson, TN 38305-3856 | 2017-03-03 |
| 1255782843 | Seth Tyler Koehler | Family Medicine | 2600 E Main St, Jackson, MO 63755-2473 | 2016-06-25 |
| 1720495245 | Gopi Patel | Family Medicine | 27 S Cooks Bridge Rd Ste 2-1, Jackson, NJ 08527-2524 | 2014-07-16 |
| 1154735165 | Lk Physicians Services Pllc | Family Medicine | 36 Lake Pointe Dr, Jackson, TN 38305-8113 | 2014-06-17 |
| 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.