NPIMap

Organization Active NPI

Medical Foundation of Central Ms, Inc

Doing business as Baptist Medical Clinic-Reservoir

  • Family Medicine Physician
  • Brandon, MS
National Provider Identifier
1144659178
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MS, INC
Doing business as
Baptist Medical Clinic-Reservoir
Practice address
1887 Spillway Rd.
Brandon, MS 39047
Phone
(601) 992-5532
Fax
(601) 992-5547
NPI assigned
Nov 12, 2013
Last updated
Nov 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1887 Spillway Rd.
Brandon, MS 39047

Mailing address

1887 Spillway Rd.
Brandon, MS 39047
Phone (601) 992-5532

Other names 1

  • Baptist Medical Clinic-Reservoir Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Jackson Heart Cardiology Clinic-Yazoo City43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1144659178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 SPILLWAY RD.",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "601-992-5532",
            "fax_number": "601-992-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 SPILLWAY RD.",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "601-992-5532",
            "fax_number": "601-992-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT MBHS CLINICS",
        "authorized_official_telephone_number": "601-292-4261"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Clinic-Reservoir",
            "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 Nov 12, 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.