NPIMap

Organization Active NPI

Baptist Jackson Heart Cardiology Clinic-Kosciusko

  • Cardiovascular Disease Physician
  • Jackson, MS
National Provider Identifier
1013280494
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BAPTIST JACKSON HEART CARDIOLOGY CLINIC-KOSCIUSKO
Practice address
1600 N State St
Suite 400
Jackson, MS 39202-1689
Phone
(601) 982-7850
Fax
(601) 944-9780
NPI assigned
Feb 16, 2012
Last updated
Feb 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Elizabeth Mullins
Title
President-MBHS
Phone
(601) 292-4261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

1600 N State St
Suite 400
Jackson, MS 39202-1689

Mailing address

1600 N State St
Suite 400
Jackson, MS 39202-1689
Phone (601) 982-7850

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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1013280494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N STATE ST",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021689",
            "telephone_number": "601-982-7850",
            "fax_number": "601-944-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N STATE ST",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021689",
            "telephone_number": "601-982-7850",
            "fax_number": "601-944-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST JACKSON HEART CARDIOLOGY CLINIC-KOSCIUSKO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT-MBHS",
        "authorized_official_telephone_number": "601-292-4261"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 16, 2012; 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.