NPIMap

Organization Active NPI

Methodist Children'S Homes

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Jackson, MS
National Provider Identifier
1770901688
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
METHODIST CHILDREN'S HOMES
Practice address
805 N Flag Chapel Rd
Jackson, MS 39209-2208
Phone
(601) 853-5000
NPI assigned
Mar 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Authorized official

Name
Mr. Devon Loggins, LCSW
Title
Vice President of Programs
Phone
(601) 853-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MS Primary

Addresses

Primary practice location

805 N Flag Chapel Rd
Jackson, MS 39209-2208

Mailing address

805 N Flag Chapel Rd
Jackson, MS 39209-2208

Other identifiers 1

IdentifierTypeStateIssuer
03078895MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Methodist Children'S Homes4 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": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1770901688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N FLAG CHAPEL RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392092208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N FLAG CHAPEL RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392092208",
            "telephone_number": "601-853-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST CHILDREN'S HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "LOGGINS",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PROGRAMS",
        "authorized_official_telephone_number": "601-853-5000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03078895",
            "state": "MS"
        }
    ],
    "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 Mar 29, 2014; 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.