NPIMap

Organization Active NPI

Mississippi State University

Doing business as John C Longest Student Health Center

  • Student Health Clinic/Center
  • Mississippi State, MS
National Provider Identifier
1225012255
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
MISSISSIPPI STATE UNIVERSITY
Doing business as
John C Longest Student Health Center
Practice address
360 Hardy Rd
Mississippi State, MS 39762
Phone
(662) 325-2431
Fax
(662) 325-8888
NPI assigned
Dec 2, 2005
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSISSIPPI STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Daniel T Hale
Title
Clinic Business Administrator
Phone
(662) 325-5895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

360 Hardy Rd
Mississippi State, MS 39762

Mailing address

PO Box 6338
Mississippi State, MS 39762-6338
Phone (662) 325-2431

Other identifiers 1

IdentifierTypeStateIssuer
09012379MedicaidMS

Other names 1

  • John C Longest Student 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
O20080723000051 MS Part B Supplier - Clinic/Group Practice 1254404320 Receives reassigned benefits from 10 practitioners
Practice locations: Mississippi State, MS

National Provider Directory

National Provider Directory
Tax ID family
Msu Longest Student Hea10 organizations share this tax ID, including this one
Part of
Msu Longest Student Hea

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1225012255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6338",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "397626338",
            "telephone_number": "662-325-2431",
            "fax_number": "662-325-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HARDY RD",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "39762",
            "telephone_number": "662-325-2431",
            "fax_number": "662-325-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSISSIPPI STATE UNIVERSITY",
        "enumeration_date": "2005-12-02",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CLINIC BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "662-325-5895"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012379",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John C Longest Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John C Longest Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mississippi State, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.