Central Mississippi Health Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CENTRAL MISSISSIPPI HEALTH SERVICES, INC

Practice address

1134 Winter St
Jackson, MS 39204-2841

Phone

(601) 948-5572

Fax

(601) 914-3012

NPI assigned

Nov 17, 2021

Organization subpart

Yes

Parent organization

CENTRAL MISSISSIPPI HEALTH SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Terry Johnson

Title

Human Resource Manager

Phone

(601) 948-5572

Specialties & licenses 1

Addresses

Other names 1

• Central MS Health Service Mobile Unit Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Central Mississippi Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1003470758

  O20040225000632

  Same enrollment
• Central Mississippi Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1730120502

  O20040225000632

  Same enrollment
• Central Mississippi Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Tougaloo, MS
  • NPI 1982746087

  O20040225000632

  Same enrollment
• Central Mississippi Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1356483283

  O20040225000632

  Same enrollment

Tax ID family

Denzil G Robertson2 organizations share this tax ID, including this one

Part of

Denzil G Robertson

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Mississippi Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1073069498
  NPD tax ID

Locations

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

• Keneisha Dean

  • Family Medicine Physician
  • Canton, MS
  • NPI 1295344224
  NPD
• Annisha Jones

  • Primary Care Nurse Practitioner
  • Clinton, MS
  • NPI 1851940951
  NPD
• Angela Carr Robinson, FNP

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1841916806
  NPD

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1386301059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 WINTER ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392042841",
            "telephone_number": "601-948-5572",
            "fax_number": "601-914-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 WINTER ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392042841",
            "telephone_number": "601-948-5572",
            "fax_number": "601-914-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MISSISSIPPI HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL MISSISSIPPI HEALTH SERVICES, INC",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "HUMAN RESOURCE MANAGER",
        "authorized_official_telephone_number": "601-948-5572"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jackson",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1134 Winter St",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392042841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Central MS Health Service Mobile Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Mississippi Civic Improvement Association, Inc.
• Central Mississippi Civic Improvement Association, Inc.
• Central Mississippi Civic Improvement Association, Inc.
• Central Mississippi Civic Improvement Association, Inc.
• Central Mississippi Health Services, Inc
• Central Mississippi Health Services, Inc
• Central Mississippi Health Services, Inc.
• Central Mississippi Health Services, Inc.
• Central Mississippi Improvement Association
• Central Mississippi Medical Center

• All providers in Jackson, MS
• Federally Qualified Health Center (FQHC) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.