NPIMap

Organization Active NPI

Reddix Medical Group

  • Clinic/Center
  • Jackson, MS
National Provider Identifier
1720213069
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REDDIX MEDICAL GROUP
Practice address
5903 Ridgewood Rd
Suite 310
Jackson, MS 39211-3700
Phone
(601) 899-3310
Fax
(601) 899-3314
NPI assigned
May 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Authorized official

Name
Ms. Gloria Grennell
Title
Office Manager
Phone
(601) 899-3310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MS Primary

Addresses

Primary practice location

5903 Ridgewood Rd
Suite 310
Jackson, MS 39211-3700

Mailing address

5903 Ridgewood Rd
Suite 310
Jackson, MS 39211-3700
Phone (601) 899-3310

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1720213069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5903 RIDGEWOOD RD",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113700",
            "telephone_number": "601-899-3310",
            "fax_number": "601-899-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5903 RIDGEWOOD RD",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113700",
            "telephone_number": "601-899-3310",
            "fax_number": "601-899-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDIX MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "GRENNELL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-899-3310",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "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 May 15, 2009; 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.