NPIMap

Organization Active NPI

Medical Foundation of Central Ms

Doing business as Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
National Provider Identifier
1114264264
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MS
Doing business as
Baptist Medical Clinic-Brandon
Practice address
1490 W Government St
Suite 10
Brandon, MS 39042-3024
Phone
(601) 825-1936
Fax
(601) 825-1937
NPI assigned
Jan 9, 2013
Last updated
Jan 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Elizabeth Mullins
Title
President Baptist Medical Clinics
Phone
(601) 292-4261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1490 W Government St
Suite 10
Brandon, MS 39042-3024

Mailing address

1490 W Government St
Suite 10
Brandon, MS 39042-3024
Phone (601) 825-1936

Other names 1

  • Baptist Medical Clinic-Brandon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000380 MS Part B Supplier - Clinic/Group Practice 1153216411 Receives reassigned benefits from 436 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kosciusko, MS; Madison, MS; McComb, MS; Meridian, MS; Pearl, MS; Richland, MS; Winona, MS; Yazoo City, MS…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

151 E Metro Dr
Ste 106
Flowood, MS 39232
Phone (601) 664-7191

5341 Lakeland Dr
Flowood, MS 39232
Phone (601) 919-1300

1190 N State St
Ste 403
Jackson, MS 39202
Phone (601) 353-2020

1200 N State St
Ste 280
Jackson, MS 39202
Phone (601) 714-6470

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

1225 N State St
Ste 100
Jackson, MS 39202
Phone (601) 360-8067

501 Marshall St
Ste 203
Jackson, MS 39202
Phone (601) 355-3353

501 Marshall St
Ste 302
Jackson, MS 39202
Phone (601) 969-7047

501 Marshall St
Ste G7
Jackson, MS 39202
Phone (601) 292-4261

6250 Old Canton Rd
Ste 130
Jackson, MS 39211
Phone (601) 956-7280

7275 S Siwell Rd
Jackson, MS 39272
Phone (601) 373-7722

334 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-1800

401 Baptist Dr
Ste 406
Madison, MS 39110

360 Simpson Highway 149
Ste 270
Magee, MS 39111

Practitioners & affiliated clinicians

Practitioners 420

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.

View all 420

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1114264264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 W GOVERNMENT ST",
            "address_2": "SUITE 10",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423024",
            "telephone_number": "601-825-1936",
            "fax_number": "601-825-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 W GOVERNMENT ST",
            "address_2": "SUITE 10",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423024",
            "telephone_number": "601-825-1936",
            "fax_number": "601-825-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT BAPTIST MEDICAL CLINICS",
        "authorized_official_telephone_number": "601-292-4261"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Clinic-Brandon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.