NPIMap

Organization Active NPI

Jeans Non Medical Care Respite

  • Respite Care
  • Sledge, MS
National Provider Identifier
1154418481
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
JEANS NON MEDICAL CARE RESPITE
Practice address
612 Broad Street
612
Sledge, MS 38270
Phone
(662) 382-8883
Fax
(662) 382-7776
NPI assigned
Oct 6, 2006
Last updated
Dec 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Ms. Ozie D Phipps, RESPITE PROVIDER
Title
Ceo
Phone
(662) 382-8883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Primary

Addresses

Primary practice location

612 Broad Street
612
Sledge, MS 38270

Mailing address

430 Williams Ave
P. O. Box 72
Sledge, MS 38670
Phone (662) 382-8883

Other identifiers 1

IdentifierTypeStateIssuer
07354332MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Jeans Non Medical Care Respite3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1154418481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WILLIAMS AVE",
            "address_2": "P. O. BOX 72",
            "city": "SLEDGE",
            "state": "MS",
            "postal_code": "38670",
            "telephone_number": "662-382-8883",
            "fax_number": "662-382-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 BROAD STREET",
            "address_2": "612",
            "city": "SLEDGE",
            "state": "MS",
            "postal_code": "38270",
            "telephone_number": "662-382-8883",
            "fax_number": "662-382-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANS NON MEDICAL CARE RESPITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "OZIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-382-8883",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RESPITE PROVIDER"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07354332",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sledge, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.