NPIMap

Organization Active NPI

Medical Foundation of Central Mississippi, Inc.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Jackson, MS
National Provider Identifier
1003098096
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC.
Practice address
1200 N State St
Suite 420
Jackson, MS 39202-2001
Phone
(601) 355-3353
Fax
(601) 355-3365
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth H. Mullins
Title
Director of Clinic Administration
Phone
(601) 292-4261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X Primary

Addresses

Primary practice location

1200 N State St
Suite 420
Jackson, MS 39202-2001

Mailing address

PO Box 2153
Dept 1947
Birmingham, AL 35287-0001
Phone (601) 355-3353

Other identifiers 3

IdentifierTypeStateIssuer
01627892MedicaidMS
C02783OtherMSMEDICARE GROUP NUMBER
DA0407OtherRR MEDICARE

Other names 1

  • Baptist Neurological Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000380 MS Part B Supplier - Clinic/Group Practice 1153216411 Receives reassigned benefits from 436 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kosciusko, MS; Madison, MS; McComb, MS; Meridian, MS; Pearl, MS; Richland, MS; Winona, MS; Yazoo City, MS…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1003098096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153",
            "address_2": "DEPT 1947",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352870001",
            "telephone_number": "601-355-3353",
            "fax_number": "601-355-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE 420",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022001",
            "telephone_number": "601-355-3353",
            "fax_number": "601-355-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC ADMINISTRATION",
        "authorized_official_telephone_number": "601-292-4261"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01627892",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02783",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA0407",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Neurological Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.