The Pain Clinic of Mississippi, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

THE PAIN CLINIC OF MISSISSIPPI, PLLC

Practice address

5903 Ridgewood Rd
Suite 440
Jackson, MS 39211-3700

Phone

(601) 899-3989

Fax

(601) 899-3504

NPI assigned

Mar 8, 2012

Last updated

Mar 8, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Duane Williamson, M.D.

Title

President

Phone

(601) 899-3989

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1063786036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "800-232-5703",
            "fax_number": "334-395-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5903 RIDGEWOOD RD",
            "address_2": "SUITE 440",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113700",
            "telephone_number": "601-899-3989",
            "fax_number": "601-899-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAIN CLINIC OF MISSISSIPPI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-899-3989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Cutaneous Laser Center
• The Joint Injection Clinic LLC (The Joint Injection Clinic)
• The Journey of Knowledge
• The Kristian Jacob Autism Center
• The Medical Foundation of Central Mississippi (Baptist Valve Center)
• The Prudent Nurse (The Nurse's Station)
• The Surgical Clinic Associates, P.a.
• The University of Mississippi Medical Center
• The Wellness Connection, LLC (The Wellness Connection)
• The Womans Clinic of Ms PLLC

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.