Organization Active NPI

Integrative Skin Care of Mississippi, PLLC

  • Dermatology Physician
  • Ridgeland, MS
National Provider Identifier
1245868801
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
INTEGRATIVE SKIN CARE OF MISSISSIPPI, PLLC
Practice address
731 S Pear Orchard Rd Ste 16
Ridgeland, MS 39157-4800
Phone
(601) 672-2044
NPI assigned
Mar 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Dr. Jasmine Campbell Hollinger, MDNPI 1265729719
Title
Owner/Ceo
Phone
(769) 300-9447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

731 S Pear Orchard Rd Ste 16
Ridgeland, MS 39157-4800

Mailing address

114 Copperridge Dr
Brandon, MS 39042-3700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1245868801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 COPPERRIDGE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S PEAR ORCHARD RD STE 16",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574800",
            "telephone_number": "601-672-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE SKIN CARE OF MISSISSIPPI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "HOLLINGER",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "CAMPBELL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "769-300-9447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.