Sonny Montgomery V a M Edical Center

Primary specialty

Chronic Disease HospitalTaxonomy code 281P00000X

License

R725005 Issued in MS

Legal business name

SONNY MONTGOMERY V A M EDICAL CENTER

Practice address

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Phone

(601) 362-4471

NPI assigned

Sep 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Ruth Mack, MSN NURSINGNPI 1205935301

Title

Certified Nurse Practitioner

Phone

(601) 362-4471

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Linda Ruth Mack, NP

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1205935301
  NPD (past) Authorized official

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013014695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1973 HOUSTON RD",
            "city": "BOLTON",
            "state": "MS",
            "postal_code": "390419387",
            "telephone_number": "601-866-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONNY MONTGOMERY V A M EDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "CERTIFIED NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-362-4471",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN NURSING"
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "MS",
            "license": "R725005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solstice Dermatology, PLLC
• James Q Sones
• William David Sones Jr., M.D.
• Somjade Jay Songcharoen, MD
• Sonny Montgomer Vamc
• Lisa Allegrezza Sorey
• Mary Louise Sorey, M.S.,CCC-SLP
• Tina Renee Sorey, O.D.
• South Central Community Action Agency, Inc
• South Jackson Family Dental, PLLC

• Chronic Disease Hospital in Jackson, MS
• Providers in Jackson, MS by specialty
• Chronic Disease Hospital in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.