NPIMap

Organization Active NPI

Mid Jackson Family Health Clinic

  • Primary Care Clinic/Center
  • Jackson, MS
National Provider Identifier
1043503832
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R831972 Issued in MS
Legal business name
MID JACKSON FAMILY HEALTH CLINIC
Practice address
514C Woodrow Wilson Dr
Jackson, MS 39216
Phone
(601) 981-7198
NPI assigned
May 26, 2011
Last updated
May 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Gloria O Areghan, PHD,CFNP
Title
President
Phone
(601) 981-7198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X R831972 MS Primary

Addresses

Primary practice location

514C Woodrow Wilson Dr
Jackson, MS 39216

Mailing address

514C East Woodrow Wilson Ave
C
Jackson, MS 39216
Phone (601) 981-7198

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1043503832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514C EAST WOODROW WILSON AVE",
            "address_2": "C",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-981-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514C WOODROW WILSON DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-981-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID JACKSON FAMILY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "AREGHAN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-981-7198",
        "authorized_official_credential": "PHD,CFNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "R831972",
            "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 May 26, 2011; 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.