Jackson Neurosurgery Clinic PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

JACKSON NEUROSURGERY CLINIC PLLC

Practice address

971 Lakeland Dr
Suite 1250
Jackson, MS 39216-4643

Phone

(601) 366-1011

Fax

(601) 366-7311

NPI assigned

Oct 20, 2009

Organization subpart

No

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

Authorized official

Name

Zoe Lewis

Title

Practice Administrator

Phone

(601) 366-1011

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1265768618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 1250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-1011",
            "fax_number": "601-366-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 1250",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-1011",
            "fax_number": "601-366-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON NEUROSURGERY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ZOE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "601-366-1011"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08288260",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4238",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Medical Supply Inc
• Delilah J Jackson Moore, LICENSED COUNSELOR
• Jackson Ms Homecare
• Jackson Neurocare, PLLC
• Jackson Neurology Associates
• Jackson Oncology Associates
• Jackson Oncology Associates
• Jackson Oncology Associates, PLLC
• Jackson Oncology Associates,PLLC
• Jackson Orthopaedic Clinic, PA

• All providers in Jackson, MS
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.