Organization Active NPI

Ms School for the Deaf and Blind

  • Audiologist
  • Jackson, MS
National Provider Identifier
1083782775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AO661 Issued in MS
Legal business name
MS SCHOOL FOR THE DEAF AND BLIND
Practice address
1253 Eastover Dr
Jackson, MS 39211-6315
Phone
(601) 984-8036
Fax
(601) 984-8030
NPI assigned
Dec 1, 2006
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
Dr. Rosie Pridgen
Title
Interim Superintendent MSD
Phone
(601) 984-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AO661 MS Primary

Addresses

Primary practice location

1253 Eastover Dr
Jackson, MS 39211-6315

Mailing address

1253 Eastover Dr
Jackson, MS 39211-6315
Phone (601) 984-8036

Other identifiers 2

IdentifierTypeStateIssuer
00076026MedicaidMS
06575367MedicaidMS

National Provider Directory

National Provider Directory

Locations

1253 Eastover Dr
Jackson, MS 39211
Phone (601) 984-8036

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083782775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 EASTOVER DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116315",
            "telephone_number": "601-984-8036",
            "fax_number": "601-984-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 EASTOVER DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116315",
            "telephone_number": "601-984-8036",
            "fax_number": "601-984-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS SCHOOL FOR THE DEAF AND BLIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "INTERIM SUPERINTENDENT MSD",
        "authorized_official_telephone_number": "601-984-8203",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MS",
            "license": "AO661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00076026",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06575367",
            "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 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.