NPIMap

Organization Active NPI

Medical Foundation of Central Ms Inc

Doing business as Baptist Medical Clinic-Belhaven

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1295283687
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MS INC
Doing business as
Baptist Medical Clinic-Belhaven
Practice address
1200 N State St
Suite LL-10
Jackson, MS 39202-2000
Phone
(601) 714-6411
Fax
(601) 714-6421
NPI assigned
Sep 14, 2016
Last updated
Sep 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Authorized official

Name
Amy Grissett
Title
Executive Director
Phone
(601) 944-1717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MS Primary

Addresses

Primary practice location

1200 N State St
Suite LL-10
Jackson, MS 39202-2000

Mailing address

1200 N State St
Suite LL-10
Jackson, MS 39202-2000
Phone (601) 714-6411

Other names 1

  • Baptist Medical Clinic-Belhaven Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Jackson Heart Cardiology Clinic-Yazoo City43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

1200 N State St
Ste LL10
Jackson, MS 39202
Phone (601) 362-7280

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1295283687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE LL-10",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022000",
            "telephone_number": "601-714-6411",
            "fax_number": "601-714-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE LL-10",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022000",
            "telephone_number": "601-714-6411",
            "fax_number": "601-714-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "GRISSETT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-944-1717"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Clinic-Belhaven",
            "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 Sep 15, 2016; 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.