NPIMap

Organization Active NPI

Premier Medical Management of Mississippi, Inc

  • Endoscopy Clinic/Center
  • Jackson, MS
National Provider Identifier
1053483735
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC
Practice address
501 Marshall St
Suite 201
Jackson, MS 39202-1651
Phone
(601) 352-2273
Fax
(601) 353-4414
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Donna Lay
Title
Director of Patient'S Accounts
Phone
(601) 352-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X Primary

Addresses

Primary practice location

501 Marshall St
Suite 201
Jackson, MS 39202-1651

Mailing address

864 Wilson Dr
Suite C
Ridgeland, MS 39157-4512
Phone (601) 206-6100

Other identifiers 2

IdentifierTypeStateIssuer
00770341MedicaidMS
490004328OtherMSRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

407 S Valley St
Carthage, MS 39051
Phone (601) 298-0333

501 Marshall St
Ste 203
Jackson, MS 39202
Phone (601) 355-3353

501 Marshall St
Ste 201
Jackson, MS 39202
Phone (601) 352-2273

1202 N State St Ste 270
Jackson, MS 39202

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1053483735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 WILSON DR",
            "address_2": "SUITE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574512",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST",
            "address_2": "SUITE 201",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021651",
            "telephone_number": "601-352-2273",
            "fax_number": "601-353-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "LAY",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT'S ACCOUNTS",
        "authorized_official_telephone_number": "601-352-2273"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770341",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004328",
            "state": "MS"
        }
    ],
    "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 Sep 16, 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.