NPIMap

Organization Active NPI

Medical Foundation of Central Mississippi, Inc

Doing business as Baptist Occupational Medical Clinic - Gluckstadt

  • Family Medicine Physician
  • Madison, MS
National Provider Identifier
1508989039
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC
Doing business as
Baptist Occupational Medical Clinic - Gluckstadt
Practice address
118 Weisenberger Rd
Madison, MS 39110-5012
Phone
(601) 607-7940
Fax
(601) 607-7941
NPI assigned
Apr 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elizabeth H Mullins
Title
Director of Clinic Administration
Phone
(601) 292-4261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

118 Weisenberger Rd
Madison, MS 39110-5012

Mailing address

1151 N State St Ste 408
Jackson, MS 39202-2464
Phone (601) 292-4261

Other names 1

  • Baptist Occupational Medical Clinic - Gluckstadt Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Jackson Heart Cardiology Clinic-Yazoo City43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

118 Weisenberger Rd
Gluckstadt, MS 39110
Phone (601) 607-7940

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508989039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST STE 408",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022464",
            "telephone_number": "601-292-4261",
            "fax_number": "601-292-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 WEISENBERGER RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105012",
            "telephone_number": "601-607-7940",
            "fax_number": "601-607-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC ADMINISTRATION",
        "authorized_official_telephone_number": "601-292-4261"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Occupational Medical Clinic - Gluckstadt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.