NPIMap

Organization Active NPI

Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
National Provider Identifier
1407968738
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
09740 Issued in MS
Legal business name
MINOR MED CARE, LLC
Practice address
2860 McDowell Road Ext
Jackson, MS 39204-4238
Phone
(601) 372-1117
Fax
(601) 373-3004
NPI assigned
Aug 31, 2006
Last updated
Apr 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
John Duke
Title
Coo
Phone
(601) 665-4162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 09740 MS Primary

Addresses

Primary practice location

2860 McDowell Road Ext
Jackson, MS 39204-4238

Mailing address

215 Katherine Dr Ste a
Flowood, MS 39232-9588
Phone (601) 665-4162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000147 MS Part B Supplier - Clinic/Group Practice 7618866021 Receives reassigned benefits from 166 practitioners
1 other NPI on this enrollment
Practice locations: Jackson, MS; Raymond, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0318086Minor Med Care2860 McDowell Rd, Jackson, MS 39204Certificate of waiverDec 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Minor Med Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117

Practitioners & affiliated clinicians

Practitioners 169

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 169

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1407968738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 KATHERINE DR STE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329588",
            "telephone_number": "601-665-4162",
            "fax_number": "601-373-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 MCDOWELL ROAD EXT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392044238",
            "telephone_number": "601-372-1117",
            "fax_number": "601-373-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOR MED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "601-665-4162"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MS",
            "license": "09740",
            "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 Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.