NPIMap

Organization Active NPI

Jaquith Nursing Home - Madison Inn

  • Nursing Facility/Intermediate Care Facility
  • Whitfield, MS
National Provider Identifier
1336229871
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
945 Issued in MS
Legal business name
JAQUITH NURSING HOME - MADISON INN
Practice address
3550 Hwy 468 West
Whitfield, MS 39193-0157
Phone
(601) 351-8000
Fax
(601) 351-8586
NPI assigned
Oct 17, 2006
Last updated
Jun 8, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSISSIPPI STATE HOSPITAL AT WHITFIELDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Authorized official

Name
Mr. James G Chastain
Title
Director
Phone
(601) 351-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 945 MS Primary

Addresses

Primary practice location

3550 Hwy 468 West
Whitfield, MS 39193-0157

Mailing address

P.O. Box 1 Fiscal Services
3550 Hwy 468 West
Whitfield, MS 39193-0157
Phone (601) 351-8000

Other identifiers 1

IdentifierTypeStateIssuer
00230127MedicaidMS

Other names 1

  • Jaquith Nursing Home - Madison Inn Other name

National Provider Directory

National Provider Directory
Tax ID family
Jaquith Nursing Home - Jaquith Inn21 organizations share this tax ID, including this one
Part of
Jaquith Nursing Home - Jaquith Inn

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496880000000",
    "number": "1336229871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1 FISCAL SERVICES",
            "address_2": "3550 HWY 468 WEST",
            "city": "WHITFIELD",
            "state": "MS",
            "postal_code": "391930157",
            "telephone_number": "601-351-8000",
            "fax_number": "601-351-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 HWY 468 WEST",
            "city": "WHITFIELD",
            "state": "MS",
            "postal_code": "391930157",
            "telephone_number": "601-351-8000",
            "fax_number": "601-351-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAQUITH NURSING HOME - MADISON INN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSISSIPPI STATE HOSPITAL AT WHITFIELD",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-06-08",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-351-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MS",
            "license": "945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00230127",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jaquith Nursing Home - Madison Inn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Whitfield, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.