NPIMap

Organization Active NPI

Mississippi State University

  • Family Medicine Physician
  • Mississippi State, MS
National Provider Identifier
1356208367
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MISSISSIPPI STATE UNIVERSITY
Practice address
195 Lee Blvd
Mississippi State, MS 39762-9698
Phone
(662) 325-5895
Fax
(662) 325-8888
NPI assigned
Jan 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Daniel Todd Hale
Title
Director, Fiscal Operations, Studen
Phone
(662) 325-5895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

195 Lee Blvd
Mississippi State, MS 39762-9698

Mailing address

PO Box 6338
Mississippi State, MS 39762-6338
Phone (662) 325-5895

National Provider Directory

National Provider Directory
Tax ID family
Mississippi State University10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

195 Lee Blvd
Mississippi State, MS 39762
Phone (662) 325-5895

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1356208367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6338",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "397626338",
            "telephone_number": "662-325-5895",
            "fax_number": "662-325-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 LEE BLVD",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "397629698",
            "telephone_number": "662-325-5895",
            "fax_number": "662-325-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "DIRECTOR, FISCAL OPERATIONS, STUDEN",
        "authorized_official_telephone_number": "662-325-5895"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mississippi State, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.