NPIMap

Organization Active NPI

Medical Foundation, Inc.

Doing business as Ochsner Health Center- Southeast

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1346939972
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MEDICAL FOUNDATION, INC.
Doing business as
Ochsner Health Center- Southeast
Practice address
2402A Long Creek Rd
Meridian, MS 39301-7594
Phone
(601) 490-9410
Fax
(855) 852-1209
NPI assigned
May 1, 2023
Last updated
May 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Don Larkin Kennedy
Title
Regional Ceo
Phone
(601) 703-9614

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

2402A Long Creek Rd
Meridian, MS 39301-7594

Mailing address

Dept 3020
PO Box 1000
Memphis, TN 38148
Phone (601) 213-3010

Other names 1

  • Ochsner Health Center- Southeast Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2162920Ochsner Health Center - Southeast2402A Long Creek Rd, Meridian, MS 39301Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Betty a Blasi NP11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

2402A Long Creek Rd
Meridian, MS 39301
Phone (601) 282-3271

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1346939972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3020",
            "address_2": "PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38148",
            "telephone_number": "601-213-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402A LONG CREEK RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393017594",
            "telephone_number": "601-490-9410",
            "fax_number": "855-852-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "REGIONAL CEO",
        "authorized_official_telephone_number": "601-703-9614"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ochsner Health Center- Southeast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.