Active NPI
Mea Primary Care Plus LLC
- Family Medicine Physician
- Jackson, MS
National Provider Identifier
1376088302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MEA PRIMARY CARE PLUS LLC
- Practice address
- 5606 Old Canton Rd
Jackson, MS 39211-4217 - Phone
- (601) 957-3333
- NPI assigned
- Dec 29, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wayne Whitley
- Title
- Ceo
- Phone
- (601) 898-7500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
5606 Old Canton Rd
Jackson, MS 39211-4217
Mailing address
308 Corporate Dr
Ridgeland, MS 39157-8803
Other practice location 1
5005 Old Canton Rd
Jackson, MS 39211-5421
Phone (601) 957-3333
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674777600000",
"number": "1376088302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 CORPORATE DR",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606 OLD CANTON RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392114217",
"telephone_number": "601-957-3333"
}
],
"practiceLocations": [
{
"address_1": "5005 Old Canton Rd",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392115421",
"country_code": "US",
"telephone_number": "601-957-3333",
"fax_number": "601-957-3335",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MEA PRIMARY CARE PLUS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-29",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A",
"authorized_official_last_name": "WHITLEY",
"authorized_official_first_name": "WAYNE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "601-898-7500"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.