CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC (NPI# 1972535250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972535250 |
| Entity Type | Organization |
| Organization Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC |
| Other Organization Name | JACKSON-HINDS COMPREHENSIVE HEALTH CENTER |
| Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
| Practice Telephone | 6013625321 |
| Practice Fax Number | 6013642600 |
| Mailing Telephone | 6013625321 |
| Mailing Fax Number | 6013642600 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-10-29 |
| Authorized Official Name | DR. JASMIN R CHAPMAN (CEO) |
| Authorized Official Telephone | 6013625321 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014686 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson-Hinds Comprehensive Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689047292 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3930 Skyview Dr, Jackson, MS 39213-5318 | 2015-11-04 |
| 1134592777 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 415 Claiborne Ave, Jackson, MS 39209-5321 | 2015-11-04 |
| 1205021946 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 327 S Gallatin St, Jackson, MS 39203-3514 | 2007-09-06 |
| 1700813052 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 129 White Oak St, Utica, MS 39175-8803 | 2006-06-26 |
| 1932145539 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 1203 Mission Park Dr, Vicksburg, MS 39180-3747 | 2006-06-21 |
| 1760420335 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 550 Caldwell Dr, Hazlehurst, MS 39083-2304 | 2006-06-03 |
| 1811425291 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 7255 Gary Rd, Byram, MS 39272-8947 | 2017-05-30 |
| 1689047201 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 386 Raymond Rd, Jackson, MS 39204-3700 | 2015-11-04 |
| 1548342611 | Central Mississippi Civic Improvement Association, Inc | Pharmacy | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-10-19 |
| 1134151442 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
| Street Address |
3502 W NORTHSIDE DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
| 1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
| 1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
| 1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
| 1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
| 1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
| 1356810360 | Thrishanna Clark | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-11-19 |
| 1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
| 1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
| 1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689047292 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 3930 Skyview Dr, Jackson, MS 39213-5318 | 2015-11-04 |
| 1134592777 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 415 Claiborne Ave, Jackson, MS 39209-5321 | 2015-11-04 |
| 1588088025 | Southside Medical Center, Inc. | Clinic/Center | 176 Lyons St, Jackson, GA 30233-2134 | 2014-02-04 |
| 1326328311 | Rural Health Services, Inc. | Clinic/Center | 210 Atomic Rd, Jackson, SC 29831-3409 | 2011-08-22 |
| 1427377266 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 350 Woodrow Wilson Blvd, Jackson, MS 39213-4454 | 2010-05-19 |
| 1376732313 | Central Mississippi Civic Improvement Association | Clinic/Center | 1716 Isable St, Jackson, MS 39204-2352 | 2007-10-16 |
| 1447448667 | Central Mississippi Civic Improvement Association | Clinic/Center | 2185 Fortune St, Jackson, MS 39204-2333 | 2007-10-12 |
| 1205021946 | Central Mississippi Civic Improvement Association, Inc | Clinic/Center | 327 S Gallatin St, Jackson, MS 39203-3514 | 2007-09-06 |
| 1598893547 | Rural Health Group, Inc. | Clinic/Center | 9409 Nc Hwy 305, Jackson, NC 27845-0594 | 2007-03-01 |
| 1023100955 | Community Action Committee of Pike County | Clinic/Center | 14590 State Route 93, Jackson, OH 45640-8977 | 2006-09-28 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.
| 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.