NPIMap

Organization Active NPI

Jackson Eye Institute PLLC

  • Ophthalmology Physician
  • Jackson, MS
National Provider Identifier
1467555250
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JACKSON EYE INSTITUTE PLLC
Practice address
2500 Lakeland Dr
Ste a
Jackson, MS 39232
Phone
(601) 939-0079
Fax
(601) 939-6823
NPI assigned
Sep 7, 2006
Last updated
Oct 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
James Alvin Bruce Jr., MDNPI 1114020906
Title
Owner
Phone
(601) 939-0079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2500 Lakeland Dr
Ste a
Jackson, MS 39232

Mailing address

2500 Lakeland Dr
Ste a
Jackson, MS 39232
Phone (601) 939-0079

Other identifiers 1

IdentifierTypeStateIssuer
07930325MedicaidMS

National Provider Directory

National Provider Directory

Locations

5310 Highway 25
Ste 5
Flowood, MS 39232
Phone (601) 919-0040

2500 Lakeland Dr
Ste A
Jackson, MS 39232
Phone (601) 939-0079

Practitioners & affiliated clinicians

Practitioners 4

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1467555250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 LAKELAND DR",
            "address_2": "STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-939-0079",
            "fax_number": "601-939-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LAKELAND DR",
            "address_2": "STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-939-0079",
            "fax_number": "601-939-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON EYE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-939-0079",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07930325",
            "state": "MS"
        }
    ],
    "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 Oct 20, 2010; 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.