State of Mississippi - University of Mississippi Medical Center
Organization Active NPI Pediatric Skilled Nursing Facility · Jackson, MS
NPI 1114727385 · NPPES record last updated Mar 17, 2025
Key facts
- NPI
- 1114727385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Skilled Nursing Facility 3140N1450X
- Legal business name
- STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
- Practice address
- 3850 Eastwood Drive
Jackson, MS 39211 - Phone
- (601) 984-2972
- NPI assigned
- Mar 17, 2025
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Grimsley
- Title
- Associate Cfo-Clinical Operations
- Phone
- (601) 815-6270
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Sigurds O Krolls MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | Yes |
Addresses
Primary practice location
3850 Eastwood Drive
Jackson, MS 39211
Mailing address
PO Box 11407
Birmingham, AL 35246-3035
Phone (601) 496-9782
Other names
- Alyce G. Clarke Center for Medically Fragile Children
Other providers in Jackson, MS
- William Mark Stanton
- Brandon Luke Staple
- Starlight ABA Ms LLC
- Elizabeth Starnes
- State of Mississippi - University of Mississippi Medical Center
- State of Mississippi - University of Mississippi Medical Center
- State of Mississippi - University of Mississippi Medical Center
- State of Mississippi - University of Mississippi Medical Center
- State of Mississippi - University of Mississippi Medical Center
- State of Mississippi - University of Mississippi Medical Center
All providers in Jackson, MS · Pediatric Skilled Nursing Facility in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.