NPIMap

Organization Active NPI

Jackson Oncology Associates

  • Hematology & Oncology Physician
  • Jackson, MS
National Provider Identifier
1295776136
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
JACKSON ONCOLOGY ASSOCIATES
Doing business as
Jackson Oncology Associates
Practice address
1227 N State St
Ste 101
Jackson, MS 39202-2002
Phone
(601) 355-2485
Fax
(601) 353-1463
NPI assigned
Jun 10, 2006
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Richard W Griffith
Title
Executive Director
Phone
(601) 974-5578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

1227 N State St
Ste 101
Jackson, MS 39202-2002

Mailing address

1227 N State St
Ste 101
Jackson, MS 39202-2002
Phone (601) 355-2485

Other identifiers 1

IdentifierTypeStateIssuer
03330710MedicaidMS

Other names 1

  • JACKSON ONCOLOGY ASSOCIATES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040109000050 MS Part B Supplier - Clinic/Group Practice 2860392735 Receives reassigned benefits from 16 practitioners
Practice locations: Vicksburg, MS; Jackson, MS
O20100930056055 MS DME Supplier - Pharmacy 2860392735 Practice locations: Jackson, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Jackson Oncology Associatespllc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2969 Curran Dr N
Ste 200
Jackson, MS 39216
Phone (601) 974-5600

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1295776136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 N STATE ST",
            "address_2": "STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022002",
            "telephone_number": "601-355-2485",
            "fax_number": "601-353-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 N STATE ST",
            "address_2": "STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022002",
            "telephone_number": "601-355-2485",
            "fax_number": "601-353-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON ONCOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-974-5578"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03330710",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON ONCOLOGY ASSOCIATES",
            "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 Nov 9, 2021; 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.