Active NPI
Recovery Specialists of Mid South, LLC
- Prevention Professional
- Jackson, TN
National Provider Identifier
1417599747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 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
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2090872 | Recovery Specialists of the Mid South | Certificate of waiver | Feb 1, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Addiction Medicine (Family Medicine) Physician
- Jackson, TN
- NPI 1114981560
-
- Cardiovascular Disease Physician
- Jackson, TN
- NPI 1912143991
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.