NPIMap

Organization Active NPI

Jackson Public Schools Clausell Clinic

  • Student Health Clinic/Center
  • Jackson, MS
National Provider Identifier
1659527414
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
JACKSON PUBLIC SCHOOLS CLAUSELL CLINIC
Practice address
618 S President St
Jackson, MS 39201-5601
Phone
(601) 960-8705
NPI assigned
Aug 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Mrs. Tammy Darlene Crocker, R.N.
Title
Lead Nurse
Phone
(601) 209-4456

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WS0200X R557579 MS
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

618 S President St
Jackson, MS 39201-5601

Mailing address

3330 Harley St
Jackson, MS 39209-7239
Phone (601) 960-8705

National Provider Directory

National Provider Directory
Tax ID family
Jackson Public School District13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

3330 Harley St
Jackson, MS 39209

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1659527414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 HARLEY ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097239",
            "telephone_number": "601-960-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S PRESIDENT ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392015601",
            "telephone_number": "601-960-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PUBLIC SCHOOLS CLAUSELL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "LEAD NURSE",
        "authorized_official_telephone_number": "601-209-4456",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, School",
            "state": "MS",
            "license": "R557579",
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 13, 2008; 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.