NPIMap

Organization Active NPI

Mississippi State Department of Health

  • Public Health or Welfare Agency
  • Brandon, MS
National Provider Identifier
1356487797
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Practice address
100 Tamberline St
Brandon, MS 39042-3164
Phone
(601) 825-2141
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mitchell Adcock
Title
Chief Operations Officer
Phone
(601) 576-7635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

100 Tamberline St
Brandon, MS 39042-3164

Mailing address

PO Box 1700
Jackson, MS 39215-1700

Other identifiers 1

IdentifierTypeStateIssuer
00650845MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Mississippi State Department of Health126 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356487797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392151700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TAMBERLINE ST",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423164",
            "telephone_number": "601-825-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "601-576-7635"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00650845",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.