NPIMap

Organization Active NPI

Vicksburg Hma Physician Management LLC

Doing business as Medical Associates of Vicksburg

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1437416351
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VICKSBURG HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Medical Associates of Vicksburg
Practice address
1860 Chadwick Dr
Jackson, MS 39204-3463
Phone
(601) 262-1000
Fax
(601) 262-1009
NPI assigned
Apr 17, 2012
Last updated
Nov 27, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Mr. Michael L Gingras
Title
Vice President
Phone
(239) 598-3131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1860 Chadwick Dr
Jackson, MS 39204-3463

Mailing address

5811 Pelican Bay Blvd
Suite 500
Naples, FL 34108-2733
Phone (239) 598-3131

Other names 1

  • Medical Associates of Vicksburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Vicksburg2 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

107 Front St
Ste 1159
Vidalia, LA 71373
Phone (318) 336-2218

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1437416351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 PELICAN BAY BLVD",
            "address_2": "SUITE 500",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082733",
            "telephone_number": "239-598-3131",
            "fax_number": "239-592-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-262-1000",
            "fax_number": "601-262-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKSBURG HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH MANAGEMENT ASSOCIATES, INC.",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "GINGRAS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "239-598-3131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Associates of Vicksburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 2012; 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.