NPIMap

Organization Active NPI

The Medical Foundation of Central Mississippi

Doing business as Baptist Medical Clinic - Internal Medicine

  • Internal Medicine Physician
  • Pearl, MS
National Provider Identifier
1063575058
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
THE MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI
Doing business as
Baptist Medical Clinic - Internal Medicine
Practice address
3011 Greenfield Rd
Pearl, MS 39208-8712
Phone
(601) 825-9000
Fax
(601) 825-2513
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Terri Parker
Title
Clinic Coordinator
Phone
(601) 825-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

3011 Greenfield Rd
Pearl, MS 39208-8712

Mailing address

3011 Greenfield Rd
Pearl, MS 39208-8712
Phone (601) 825-9000

Other identifiers 1

IdentifierTypeStateIssuer
07634271MedicaidMS

Other names 1

  • Baptist Medical Clinic - Internal Medicine 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

Locations

346 Crossgates Blvd
Ste 201
Brandon, MS 39042
Phone (601) 825-9000

Practitioners & affiliated clinicians

Practitioners 2

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1063575058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 GREENFIELD RD",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088712",
            "telephone_number": "601-825-9000",
            "fax_number": "601-825-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 GREENFIELD RD",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088712",
            "telephone_number": "601-825-9000",
            "fax_number": "601-825-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "601-825-9000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07634271",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Clinic - Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearl, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.