NPIMap

Organization Active NPI

Julia Street Clinic, Inc.

  • Community Health Clinic/Center
  • Isola, MS
National Provider Identifier
1740310549
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
JULIA STREET CLINIC, INC.
Practice address
102 Julia Street
Isola, MS 38754
Phone
(662) 962-7923
NPI assigned
Mar 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vernita James
Title
Administrator
Phone
(662) 962-7923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

102 Julia Street
Isola, MS 38754

Mailing address

PO Box 553
Isola, MS 38754-0553
Phone (662) 962-7923

Other identifiers 1

IdentifierTypeStateIssuer
01285834MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740310549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "ISOLA",
            "state": "MS",
            "postal_code": "387540553",
            "telephone_number": "662-962-7923",
            "fax_number": "662-962-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 JULIA STREET",
            "city": "ISOLA",
            "state": "MS",
            "postal_code": "38754",
            "telephone_number": "662-962-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA STREET CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "VERNITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-962-7923"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01285834",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Isola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.