Healthstat on-Site Clinic/Unified Brands Jackson

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

Legal business name

HEALTHSTAT ON-SITE CLINIC/UNIFIED BRANDS JACKSON

Doing business as

Jackson Health and Wellness Center

Practice address

88 Armory Rd
Vicksburg, MS 39183-7431

Phone

(989) 644-3331

NPI assigned

Dec 18, 2013

Organization subpart

No

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

Authorized official

Name

Jill Johnson Patton

Title

Director of Risk Management

Phone

(704) 936-5546

Specialties & licenses 1

Addresses

Other names 1

• Jackson Health and Wellness Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Healthstat on-Site Clinicmilliken Kex237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

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

• Healthstat Health Center Southern Motion

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Pontotoc, MS
  • NPI 1780350132
  NPD tax ID
• Healthstat Inc Scan Source

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Southaven, MS
  • NPI 1710598339
  NPD tax ID
• Healthstat Onsite Clinic MVM Columbia

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Columbus, MS
  • NPI 1285016428
  NPD tax ID
• Healthstat Onsite Clinic- Parker Hannifin Chelsea

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Olive Branch, MS
  • NPI 1336543099
  NPD tax ID

Locations

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1376964379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 ARMORY RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391837431",
            "telephone_number": "989-644-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ON-SITE CLINIC/UNIFIED BRANDS JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keamber Harris
• Roy C Harris III
• Patricia Harrison
• Deirdre A Harvey, LSW
• Synette Hayden
• Breanna Heard-Pinho
• Cathy Lee Hearn
• Michael Q Hedrick, PTA
• Hendrik K Kuiper MD Inc
• Andrew Hendrix, CRNA

• Preventive Medicine/Occupational Environmental Medicine Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.