Modern Hope of Ms,LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MODERN HOPE OF MS,LLC

Practice address

16 Northtown Dr Ste 106
Jackson, MS 39211-3058

Phone

(336) 745-1499

NPI assigned

Feb 5, 2020

Organization subpart

No

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

Authorized official

Name

Jennifer King

Title

Ceo

Phone

(336) 745-1499

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1629600945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 HIGHLAND OAKS DR STE 204",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037106",
            "telephone_number": "336-745-1499",
            "fax_number": "434-549-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 NORTHTOWN DR STE 106",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113058",
            "telephone_number": "336-745-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HOPE OF MS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-745-1499"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferking@modernhopeofms.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16 Northtown Dr Ste 106",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392113058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Elizabeth Moak, M.S., CCC-SLP
• Wilson E Moak, MD
• Mobile Medic Ambulance Service Inc
• Berthrone Lacalvin Mock-Muhammad, MD
• Chelsea Lauren Mockbee, M.D.
• Aubreanna Chante Moffett
• Rhonda Moffett
• Shannon L Moffett, NP
• Jennifer Lynn Moffitt, CNNP
• Swathi Muthyam Mogulla, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.