NPIMap

Organization Active NPI

Medical Foundation of Central Mississippi, Inc

Doing business as Baptist Medical Clinic - Northtown

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1053434555
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC
Doing business as
Baptist Medical Clinic - Northtown
Practice address
6250 Old Canton Rd Ste 100
Jackson, MS 39211-2946
Phone
(601) 957-1015
Fax
(601) 956-9721
NPI assigned
Apr 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

6250 Old Canton Rd Ste 100
Jackson, MS 39211-2946

Mailing address

1151 N State St Ste 408
Jackson, MS 39202-2464
Phone (601) 292-4261

Other identifiers 1

IdentifierTypeStateIssuer
08588008MedicaidMS

Other names 1

  • Baptist Medical Clinic - Northtown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Jackson Heart Cardiology Clinic-Yazoo City43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053434555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST STE 408",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022464",
            "telephone_number": "601-292-4261",
            "fax_number": "601-292-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 OLD CANTON RD STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112946",
            "telephone_number": "601-957-1015",
            "fax_number": "601-956-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08588008",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Clinic - Northtown",
            "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 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.