NPIMap

Organization Active NPI

Statewide Healthcare Services, LLC

  • Private Vehicle
  • Jackson, MS
National Provider Identifier
1205964178
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
Legal business name
STATEWIDE HEALTHCARE SERVICES, LLC
Practice address
3829 I-55 North
Jackson, MS 39211
Phone
(800) 898-0981
Fax
(601) 982-7462
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Joseph Bonaccorsi
Title
Chief Legal Officer
Phone
(312) 762-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X Primary

Addresses

Primary practice location

3829 I-55 North
Jackson, MS 39211

Mailing address

33 S State St FL 5
Chicago, IL 60603-2804
Phone (312) 762-9999

National Provider Directory

National Provider Directory
Tax ID family
Oxford Healthcare28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1205964178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S STATE ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032804",
            "telephone_number": "312-762-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 I-55 NORTH",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39211",
            "telephone_number": "800-898-0981",
            "fax_number": "601-982-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "BONACCORSI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "312-762-9999"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 16, 2022; 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.