NPIMap

Organization Active NPI

Mississippi State University

Doing business as Autism and Developmental Disabilities Clinic

  • Developmental Disabilities Clinic/Center
  • Mississippi State, MS
National Provider Identifier
1487463311
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MISSISSIPPI STATE UNIVERSITY
Doing business as
Autism and Developmental Disabilities Clinic
Practice address
695 Bully Blvd
Mississippi State, MS 39762
Phone
(662) 325-1028
NPI assigned
Jan 6, 2025
Organization subpart
Yes
Parent organization
MISSISSIPPI STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Martha Leigh Thomas
Title
Business Director
Phone
(662) 325-1028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

695 Bully Blvd
Mississippi State, MS 39762

Mailing address

PO Box 9736
Mississippi State, MS 39762-9736

Other names 1

  • Autism and Developmental Disabilities Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mississippi State University10 organizations share this tax ID, including this one
Part of
Mississippi State University

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1487463311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9736",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "397629736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 BULLY BLVD",
            "city": "MISSISSIPPI STATE",
            "state": "MS",
            "postal_code": "39762",
            "telephone_number": "662-325-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSISSIPPI STATE UNIVERSITY",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "662-325-1028"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autism and Developmental Disabilities Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mississippi State, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.