NPIMap

Organization Active NPI

Mississippi State Department of Health

  • Public Health or Welfare Agency
  • Jackson, MS
National Provider Identifier
1366853004
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Practice address
3276 Lynch St
Jackson, MS 39209-7205
Phone
(601) 969-5730
Fax
(601) 969-5729
NPI assigned
May 15, 2014
Last updated
May 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Authorized official

Name
Mr. Mitchell Adcock, CAO
Title
Chief Administrative Officer
Phone
(601) 576-7635

Specialties & licenses 1

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

Addresses

Primary practice location

3276 Lynch St
Jackson, MS 39209-7205

Mailing address

570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone (601) 576-7635

Other names 1

  • South Jackson WIC Distribution Other name

National Provider Directory

National Provider Directory
Tax ID family
Mississippi Department 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

Locations

3276 Lynch St
Jackson, MS 39209
Phone (601) 969-5730

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1366853004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-576-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 LYNCH ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097205",
            "telephone_number": "601-969-5730",
            "fax_number": "601-969-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "601-576-7635",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAO"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Jackson WIC Distribution",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.