NPIMap

Organization Active NPI

University Nursing Associates, PLLC

  • Clinic/Center
  • Jackson, MS
National Provider Identifier
1720201841
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UNIVERSITY NURSING ASSOCIATES, PLLC
Practice address
1339 Oak Park Dr
Jackson, MS 39213-6804
Phone
(601) 713-1642
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Authorized official

Name
Dr. Kim Hoover, PH.D.
Title
Managing Member
Phone
(601) 984-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1339 Oak Park Dr
Jackson, MS 39213-6804

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-6270

Other identifiers 1

IdentifierTypeStateIssuer
09014964MedicaidMS

Other names 1

  • Johnson Elementary School Health Center Doing business as

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
25D0965187Ummc - Johnson Elementary Health Center1339 Oak Park Drive, Jackson, MS 39213Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brown Elementary School Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1720201841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6270",
            "fax_number": "601-984-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 OAK PARK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392136804",
            "telephone_number": "601-713-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY NURSING ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "601-984-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014964",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Elementary School Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 21, 2009; 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.