Organization Active NPI

Recovery Specialists of Mid South, LLC

  • Prevention Professional
  • Jackson, TN
National Provider Identifier
1417599747
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
RECOVERY SPECIALISTS OF MID SOUTH, LLC
Practice address
164 W University Pkwy
Jackson, TN 38305-1621
Phone
(731) 215-1135
Fax
(731) 410-6156
NPI assigned
Oct 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Elizabeth M Cole, R.N
Title
Director/Coowner
Phone
(731) 215-1135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention ProfessionalGroup: 193400000X SINGLE SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

164 W University Pkwy
Jackson, TN 38305-1621

Mailing address

164 W University Pkwy Ste a
Jackson, TN 38305-1621
Phone (731) 215-1135

Other names 1

  • Mid South Recovery Doing business as

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
44D2090872Recovery Specialists of the Mid South164 W University Pkwy, Suite a, Jackson, TN 38305Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory

Locations

164 W University Pkwy
Ste A
Jackson, TN 38305
Phone (731) 215-1135

164 W University Pkwy
Jackson, TN 38305
Phone (731) 215-1135

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1417599747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W UNIVERSITY PKWY STE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051621",
            "telephone_number": "731-215-1135",
            "fax_number": "731-410-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W UNIVERSITY PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051621",
            "telephone_number": "731-215-1135",
            "fax_number": "731-410-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY SPECIALISTS OF MID SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/COOWNER",
        "authorized_official_telephone_number": "731-215-1135",
        "authorized_official_credential": "R.N"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid South Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mid South Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.