NPIMap

Organization Active NPI

App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1730687740
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
APP OF MISSISSIPPI ED, LLC
Practice address
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone
(629) 203-7320
NPI assigned
Jan 24, 2018
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
James Grimes
Title
Cfo
Phone
(855) 246-8607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1850 Chadwick Dr
Jackson, MS 39204-3404

Mailing address

5121 Maryland Way Ste 300
Brentwood, TN 37027-7516
Phone (629) 203-7320

Other practice location 1

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (629) 203-7320

Other practice location 2

350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (629) 203-7320

Other practice location 3

150 Reynoir St
Biloxi, MS 39530-4130
Phone (629) 203-7320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180313002534 MS Part B Supplier - Clinic/Group Practice 3971865858 Receives reassigned benefits from 202 practitioners
Practice locations: Vicksburg, MS; Natchez, MS; Jackson, MS; Brandon, MS; Hattiesburg, MS; Biloxi, MS

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 204

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 204

NPI Registry JSON

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1730687740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277516",
            "telephone_number": "629-203-7320",
            "fax_number": "629-216-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "629-203-7320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 Hardy St",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021308",
            "country_code": "US",
            "telephone_number": "629-203-7320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Crossgates Blvd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390422601",
            "country_code": "US",
            "telephone_number": "629-203-7320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Reynoir St",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395304130",
            "country_code": "US",
            "telephone_number": "629-203-7320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "APP OF MISSISSIPPI ED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-24",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "855-246-8607"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "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 Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.