Central Mississippi Medical Clinic PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTRAL MISSISSIPPI MEDICAL CLINIC PLLC

Practice address

2200 Highway 61 N Ste 2100
Vicksburg, MS 39183-8246

Phone

(601) 955-3223

NPI assigned

Oct 13, 2025

Last updated

Oct 13, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Walker BlackstonNPI 1194834747

Title

Owner

Phone

(601) 955-3223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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.

• Joseph W Blackston, MD

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1194834747
  Medicare reassignment Care Compare group NPD Authorized official
• Marika Zarafyan Simmons, PA

  • Physician Assistant
  • Byram, MS
  • NPI 1154959526
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1316813868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 PETIT BOIS ST N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116707",
            "telephone_number": "601-955-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HIGHWAY 61 N STE 2100",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838246",
            "telephone_number": "601-955-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MISSISSIPPI MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BLACKSTON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-955-3223"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Joseph Caulfield, PA-C
• CDS Home Care, Inc. (CDS Home Care)
• Central Mississippi Civic Improvement Association (Jackson Hinds Comprehensive Health Center)
• Central Mississippi Civic Improvement Association (Jackson Hinds Comprehensive Health Center)
• Central Mississippi Civic Improvement Association, Inc (Jackson Hinds Comprehensive Health Center)
• Central Mississippi Prevention Services Inc
• Central Mississippi Vascular Care, LLC (Central Mississippi Vascular Care)
• Martin V Chaney, D.M.D.
• Suzanne Channell, ATC, LAT, MBA
• Kathleen Chappelear, LCSW

• Internal Medicine Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.