Mississippi Childrens Heart Clinic PLLC

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

MISSISSIPPI CHILDRENS HEART CLINIC PLLC

Practice address

1190 N State St Ste 200
Jackson, MS 39202-2413

Phone

(601) 965-6100

NPI assigned

Oct 29, 2020

Organization subpart

No

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

Authorized official

Name

Stephanie Purvis, OFFICE MANAGER

Title

Office Manager

Phone

(601) 965-6100

Specialties & licenses 1

Addresses

Other names 1

• MS Children's Heart Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Steven Braden, M.D.

  • Pediatrics Physician
  • Brookhaven, MS
  • NPI 1689697336

  MS, Pediatric Cardiology

  Medicare reassignment NPD
• Emilye Walker Welch, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1730799834

  MS

  Medicare reassignment NPD
• Onyekachukwu Jideofo Osakwe, MD MPH

  • Pediatric Cardiology Physician
  • Gainesville, FL
  • NPI 1275895559

  MS, Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1366042236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22646",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252646",
            "telephone_number": "601-944-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-965-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI CHILDRENS HEART CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "PURVIS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-965-6100",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MS Children's Heart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mississippi Center for Families
• Mississippi Children'S Home
• Mississippi Children'S Home Society
• Mississippi Children'S Home Society - Canopy Children'S Solutions
• Mississippi Children'S Home Society - Mypac
• Mississippi Commcare Corporation a Non Profit Corporation
• Mississippi Commcare Corporation a Non Profit Corporation
• Mississippi Commcare Corporation a Non Profit Corporation
• Mississippi Comprehensive Treatment Centers, LLC
• Mississippi Counseling Associates

• All providers in Jackson, MS
• Pediatric Cardiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.