Jackson Anesthesia Pain Center, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

12138 Issued in MS

Legal business name

JACKSON ANESTHESIA PAIN CENTER, LLC

Practice address

1190 N State St
Suite 300
Jackson, MS 39202-2413

Phone

(601) 709-0607

Fax

(601) 709-2110

NPI assigned

Feb 26, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Carroll M McLeod, MD

Title

Owner

Phone

(601) 709-0607

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristi M Phillips, NP-C

  • Adult Health Nurse Practitioner
  • Sterling, VA
  • NPI 1952641433
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1104166362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-709-0607",
            "fax_number": "601-709-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-709-0607",
            "fax_number": "601-709-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON ANESTHESIA PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-709-0607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MS",
            "license": "12138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J & R Optical
• Elizabeth Jabaley, MD
• Roya Jaberian Doraji, DO
• Jackiedees Transportation
• Jackson Anesthesia Associates PA
• Jackson Asthma & Allergy Center, PA
• Jackson Autism Center
• Jackson Bone and Joint
• Jackson Brace and Limb Company
• Jackson Cardiology Associates, P.a.

• All providers in Jackson, MS
• Pain Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.