University Family Medicine Associates, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

UNIVERSITY FAMILY MEDICINE ASSOCIATES, PLLC

Practice address

1410 E Woodrow Wilson Ave
Jackson, MS 39216-5114

Phone

(601) 984-5404

Fax

(601) 815-3771

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Diane Beebe, MD

Title

Chairman

Phone

(601) 984-5404

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

University Family Medicine Associates PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• University Family Medicine Associates, PLLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1326244989
  NPD tax ID

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093913634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4999",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964999",
            "telephone_number": "601-984-5404",
            "fax_number": "601-815-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165114",
            "telephone_number": "601-984-5404",
            "fax_number": "601-815-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY FAMILY MEDICINE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEEBE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "601-984-5404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014106",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014130",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Univ OB/GYN Assoc.,PLLC
• Univ Prev Med Assocs PLLC
• University Anesthesia Services, PLLC
• University Emergency Physicians, PLLC
• University Emergency Physicians, PLLC
• University Family Medicine Associates, PLLC
• University Family Medicine Associates, PLLC
• University Hospital
• University Internal Medicine Assoc LLP
• University Neurology Group, PLLC

• Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinic/Center in Mississippi

• 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.