NPIMap

Organization Active NPI

Mississippi State Department of Health

  • Community/Behavioral Health Agency
  • Jackson, MS
National Provider Identifier
1063558401
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Practice address
570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone
(601) 906-0879
NPI assigned
Jan 30, 2007
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Miranda Hillman
Title
Office Director
Phone
(601) 576-7886

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

570 E Woodrow Wilson Ave
Jackson, MS 39216-4538

Mailing address

570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone (601) 906-0879

Other practice location 1

100 Tamberline St
Brandon, MS 39042-3164
Phone (601) 825-2141

Other identifiers 1

IdentifierTypeStateIssuer
00016412MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Mississippi Department Health126 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1063558401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-906-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-906-0879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Tamberline St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390423164",
            "country_code": "US",
            "telephone_number": "601-825-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "HILLMAN",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "OFFICE DIRECTOR",
        "authorized_official_telephone_number": "601-576-7886"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016412",
            "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 Dec 2, 2022; 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.