MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC. (NPI# 1992774814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992774814 |
| Entity Type | Organization |
| Organization Name | MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC. |
| Other Organization Name | BAPTIST MEDICAL CLINICS |
| Practice Address |
1200 N State St Ste 270 Jackson MS 39202-2027 |
| Mailing Address |
350 N Humphreys Blvd Memphis TN 38120-2177 |
| Practice Telephone | 6019746246 |
| Practice Fax Number | 6013534414 |
| Mailing Telephone | 6012924261 |
| Mailing Fax Number | 6012924262 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-10-06 |
| 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 |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03807380 | 05 |
| Other Name | Type Code |
|---|---|
| Baptist Medical Clinics | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 S Pearson Rd, Pearl, MS 39208 | 6019681237 | 6019681246 |
| 102 Lexington Dr Ste 100, Madison, MS 391106952 | 6019731688 | 6019731690 |
| 106 Clinton Pkwy, Clinton, MS 390564730 | 6019249005 | 6019731622 |
| 108 Clinton Pkwy, Clinton, MS 390564730 | 6019262018 | 6019249746 |
| 1100 Hwy 16, Carthage, MS 39051 | 6012671000 | 6019734541 |
| 1190 N State St, Jackson, MS 392022413 | 6019731624 | 6019731596 |
| 1200 N State St # Ll10, Jackson, MS 392022000 | 6013627280 | 6013628116 |
| 1200 N State St Ste 210, Jackson, MS 392022000 | 6017143202 | 6017143416 |
| 1200 N State St Ste 420, Jackson, MS 392022027 | 6013553353 | 6013553365 |
| 1200 N State St Ste 500, Jackson, MS 392022027 | 6013522273 | 6017143215 |
| 1201 Highway 49 S Ste 1, Richland, MS 392189438 | 6019731576 | 6016640055 |
| 1225 N State St, Jackson, MS 392022064 | 6019885281 | 6019746241 |
| 123 Bo Bo Dr, Crystal Springs, MS 390592741 | 6019696404 | 6019734541 |
| 1490 W Government St Ste 10, Brandon, MS 390423024 | 6018251936 | 6018251937 |
| 151 E Metro Dr Ste 103, Flowood, MS 392324405 | 6019923288 | 6019923188 |
| 151 E Metro Dr Ste 202, Flowood, MS 392324405 | 6019731507 | 6019393332 |
| 1887 Spillway Rd, Brandon, MS 390476066 | 6019925532 | 6019925547 |
| 2173 Main St, Madison, MS 391106309 | 6016053858 | 6016053898 |
| 3011 Greenfield Rd, Pearl, MS 392088712 | 6018259000 | 6018252531 |
| 332 Highway 12 W, Kosciusko, MS 390903209 | 6012891800 | 6622892486 |
| 401 Baptist Dr Ste 104, Madison, MS 391102010 | 6016052383 | 6016053898 |
| 401 Baptist Dr Ste 206, Madison, MS 391102011 | 6019731583 | 6019731609 |
| 401 Baptist Dr Ste 306, Madison, MS 391102012 | 6016077204 | 6016077430 |
| 4301 Lakeland Dr, Flowood, MS 392328947 | 6019397010 | 6019393332 |
| 501 Marshall St Ste G07, Jackson, MS 392021651 | 6019683238 | 6019683237 |
| 6250 Old Canton Rd Ste 130, Jackson, MS 392112946 | 6019567280 | 6019776244 |
| 650 Old Canton Rd Ste 100, Jackson, MS 39211 | 6019571015 | 6019569721 |
| 7273 S Siwell Rd, Byram, MS 392729767 | 6013728223 | 6013728125 |
| 7275 S Siwell Rd, Byram, MS 392729767 | 6013737722 | 6013737378 |
| 746 E Fifteenth St, Yazoo City, MS 391942706 | 6017464032 | 6017460967 |
| 823 Grand Ave, Yazoo City, MS 391943233 | 6275182466 | 6627467855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003098096 | Medical Foundation of Central Mississippi, Inc. | Neuromusculoskeletal Medicine & OMM | 1200 N State St, Suite 420, Jackson, MS 39202-2001 | 2007-11-30 |
| Street Address |
1200 N STATE ST STE 270 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2027 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556048 | Hannah Roberts Badon | Internal Medicine | 2450 Wild Valley Dr, Jackson, MS 39211-6224 | 2020-04-12 |
| 1649809476 | Rachel Horn Mullins | Internal Medicine | 5379 Fairway St, Jackson, MS 39211-4251 | 2020-04-03 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1356605752 | Jeremy Taylor | Internal Medicine | 971 Lakeland Dr Ste 450, Jackson, MS 39216-4615 | 2012-06-29 |
| 1134416019 | Zubair Khan | Internal Medicine | 3291 Creekwood Cir, Jackson, WI 53037-8927 | 2011-06-29 |
| 1801181466 | Anne Marie Shute | Internal Medicine | 7 Windwood Dr, Jackson, TN 38305-8835 | 2011-06-12 |
| 1487945648 | Howard Carroll Friday | Internal Medicine | 4019 Old Canton Rd., Jackson, MS 39216 | 2011-04-22 |
| 1801195003 | Mahir H Alsalman | Internal Medicine | 3100 Cooper St, Jackson, MI 49201-7545 | 2011-03-28 |
| 1912138967 | Tatum Medical Clinic | Internal Medicine | 5903 Ridgewood Rd Ste 330, Jackson, MS 39211-3702 | 2009-08-06 |
| 1306089040 | Hussein Othman | Internal Medicine | 205 Page Ave Ste B, Jackson, MI 49201-2462 | 2009-04-10 |
| 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.