NPIMap

Organization Active NPI

Central Ms Pediatric Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MS
National Provider Identifier
1114118940
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CENTRAL MS PEDIATRIC ENDOCRINOLOGY
Practice address
1860 Chadwick Dr
Suite 206
Jackson, MS 39204-3463
Phone
(601) 376-1517
Fax
(601) 376-1546
NPI assigned
Aug 7, 2007
Last updated
Aug 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Brad Sinclair
Title
Regional Manager
Phone
(601) 936-3102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1860 Chadwick Dr
Suite 206
Jackson, MS 39204-3463

Mailing address

1860 Chadwick Dr
Suite 206
Jackson, MS 39204-3463
Phone (601) 376-1517

National Provider Directory

National Provider Directory
Tax ID family
Central Ms Neurosurgery40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Locations

1860 Chadwick Dr
Ste 206
Jackson, MS 39204
Phone (601) 376-1545

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1114118940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "address_2": "SUITE 206",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-376-1517",
            "fax_number": "601-376-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "address_2": "SUITE 206",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-376-1517",
            "fax_number": "601-376-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MS PEDIATRIC ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "601-936-3102"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 7, 2007; 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.