NPIMap

Organization Active NPI

State of Mississippi - University of Mississippi Medical Center

  • Eyewear Supplier
  • Jackson, MS
National Provider Identifier
1568254100
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Practice address
764 Lakeland Dr
Jackson, MS 39216-4651
Phone
(601) 984-5020
NPI assigned
May 20, 2025
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Jeffrey Grimsley
Title
Associate Cfo - Clinical Operations
Phone
(601) 815-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

764 Lakeland Dr
Jackson, MS 39216-4651

Mailing address

PO Box 11407
Birmingham, AL 35246-2130
Phone (601) 984-1000

Other names 1

  • UMMC Optical Suite Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1568254100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462130",
            "telephone_number": "601-984-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164651",
            "telephone_number": "601-984-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "GRIMSLEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "ASSOCIATE CFO - CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "601-815-6270"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMMC Optical Suite",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 20, 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.