NPIMap

Organization Active NPI

Emmanuel Health Services

Doing business as Emmanuel Medical Clinic

  • Family Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1407114432
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R845316 Issued in MS
Legal business name
EMMANUEL HEALTH SERVICES
Doing business as
Emmanuel Medical Clinic
Practice address
637 Highway 51 North
Suite E
Ridgeland, MS 39157
Phone
(601) 209-5133
NPI assigned
Apr 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Ms. Donna Kay Pittman, FNP
Title
Ceo
Phone
(601) 209-5133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X R845316 MS Primary

Addresses

Primary practice location

637 Highway 51 North
Suite E
Ridgeland, MS 39157

Mailing address

PO Box 2056
Ridgeland, MS 39158-2056
Phone (601) 605-8820

Other names 1

  • Emmanuel Medical Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Jackson

National Provider Directory

National Provider Directory

Locations

637 Highway 51
Ste E
Ridgeland, MS 39157
Phone (601) 209-5133

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1407114432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2056",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391582056",
            "telephone_number": "601-605-8820",
            "fax_number": "601-605-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 HIGHWAY 51 NORTH",
            "address_2": "SUITE E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "39157",
            "telephone_number": "601-209-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-209-5133",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R845316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jackson",
            "affiliation": "N",
            "address_1": "4612 Medgar Evers Blvd Ste 10",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392135205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Emmanuel Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emmanuel Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.