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
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
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 1

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

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 16

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

View all 16

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

National Provider Directory

National Provider Directory
Tax ID family
Jackson Oncology Associates7 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.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
IdentifierTypeStateIssuer
03330710MedicaidMS

Other names 1

NPPES NPI Registry
  • JACKSON ONCOLOGY ASSOCIATES Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2021.

{
    "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": "193400000X SINGLE SPECIALTY  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.