NPIMap

Organization Active NPI

Mississippi Baptist Medical Center, Inc.

  • Clinical Medical Laboratory
  • Jackson, MS
National Provider Identifier
1609485440
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MISSISSIPPI BAPTIST MEDICAL CENTER, INC.
Practice address
1225 N State St
Jackson, MS 39202-2064
Phone
(601) 968-3070
NPI assigned
Jul 28, 2020
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Mr. Gregory M Duckett
Title
Sr VP/Clo
Phone
(901) 227-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

1225 N State St
Jackson, MS 39202-2064

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177

Other names 1

  • MBMC Reference Laboratory Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0317980Mississippi Baptist Medical Center Laboratory1225 North State Street, Jackson, MS 39202AccreditationFeb 27, 2027
25D2288346Baptist Medical Group Pain Management1225 N State St Ste 100, Jackson, MS 39202Certificate of waiverAug 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Baptist Canton Family H11 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 10

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1609485440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "601-968-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI BAPTIST MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/CLO",
        "authorized_official_telephone_number": "901-227-5233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MBMC Reference Laboratory",
            "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 Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.