STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1699857433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699857433 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Practice Address |
2500 N State St Pfs Jackson MS 39216-4500 |
| Mailing Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6019844619 |
| Practice Fax Number | 6019844657 |
| Mailing Telephone | 6019842342 |
| Mailing Fax Number | 6019844657 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | WILLIAM KENNEDY (ASSOCIATE ADMINISTOR) |
| Authorized Official Telephone | 6019864699 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RR MEDICARE | CH5738 | 01 |
| MS | 09015456 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578011417 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 965 Avent Dr Ste 100b, Grenada, MS 38901-5045 | 2016-09-21 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1528495454 | State of Mississippi-university of Mississippi Medical Center | Clinic/Center | 965 Avent Dr Ste 107, Grenada, MS 38901-5045 | 2013-10-10 |
| 1780015396 | State of Mississippi-university of Mississippi Medical Center | Ambulance | 960 J K Avent Dr, Grenada, MS 38901-5230 | 2013-12-06 |
| 1720419583 | State of Mississippi-university of Mississippi Medical Center | General Acute Care Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1639500499 | State of Mississippi-university of Mississippi Medical Center | Durable Medical Equipment & Medical Supplies | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1831520691 | State of Mississippi-university of Mississippi Medical Center | Nurse Anesthetist, Certified Registered | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-12-04 |
| 1841620846 | State of Mississippi-university of Mississippi Medical Center | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2013-11-13 |
| 1932538527 | State of Mississippi-university of Mississippi Medical Center | Family Medicine | 965 Avent Dr, Suite 100a, Grenada, MS 38901-5045 | 2013-11-05 |
| 1083041917 | State of Mississippi-university of Mississippi Medical Center | Psychiatric Hospital | 960 Avent Dr, Grenada, MS 38901-5230 | 2013-10-10 |
| Street Address |
2500 N STATE ST PFS |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (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. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332546 | Jaleesa Atkins | Nurse Practitioner | 4266 Springbrook Rd, Jackson, MI 49201-9716 | 2020-07-01 |
| 1457983785 | Amos N Macharia | Nurse Practitioner | 2130 Ridge Rd, Jackson, MO 63755-1612 | 2020-02-05 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1851934723 | Hannah Louise Keel | Nurse Practitioner | 623 Gettysburg Dr, Jackson, TN 38305-7886 | 2019-10-23 |
| 1013559186 | Kirsten Siler | Nurse Practitioner | 27a Medical Center Drive, Jackson, TN 38301-3949 | 2019-10-10 |
| 1801447693 | Milestone Primary Care House Calls, LLC | Nurse Practitioner | 5260 Cedar Park Dr Ste E, Jackson, MS 39206-4131 | 2019-09-24 |
| 1750855870 | Michael L Chesney | Nurse Practitioner | 6055 Jordan Rd, Jackson, MI 49201-9580 | 2019-01-12 |
| 1609356500 | Angela Sophia Mcreynolds | Nurse Practitioner | 2500 N State St Rm S347, Jackson, MS 39216-4500 | 2018-08-20 |
| 1679050132 | Alicia Faye Green | Nurse Practitioner | 908 Bella Vista Dr, Jackson, MO 63755-7863 | 2018-07-26 |
| 1982119228 | Felix Taylor | Nurse Practitioner | 514 E Woodrow Wilson Ave Ste B, Jackson, MS 39216-4538 | 2017-12-08 |
| 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.