NPIMap

Organization Active NPI

Central Mississippi Civic Improvement Association, Inc.

Doing business as Jackson-Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
National Provider Identifier
1154424554
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.
Doing business as
Jackson-Hinds Comprehensive Health Center
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 362-5321
Fax
(601) 364-2600
NPI assigned
Sep 7, 2006
Last updated
Oct 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Dr. Jasmin O Chapman, DDSNPI 1811931363
Title
Ceo
Phone
(601) 364-5142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X MS Primary

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Other names 1

  • Jackson-Hinds Comprehensive Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000125 MS Part B Supplier - Clinic/Group Practice 4183533235 Receives reassigned benefits from 70 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MS; Vicksburg, MS; Utica, MS; Edwards, MS; Hazlehurst, MS

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Appleton Intensivist Group46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

Locations

550 Caldwell Dr
Hazlehurst, MS 39083
Phone (601) 894-1448

2649 Highway 80 W
Ste 301B
Jackson, MS 39204
Phone (601) 376-2999

514 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 713-3900

514 E Woodrow Wilson Ave
Ste Ab
Jackson, MS 39216
Phone (601) 321-2234

260 Highway 18
Utica, MS 39175
Phone (601) 885-6021

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1154424554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "JASMIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-364-5142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson-Hinds Comprehensive Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson-Hinds Comprehensive Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 25, 2018; 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.