NPIMap

Organization Active NPI

Jackson Oncology Associates

Doing business as Jackson Oncology Associates, PLLC Oral Dispense Pharmacy

  • Community/Retail Pharmacy
  • Jackson, MS
National Provider Identifier
1780192690
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKSON ONCOLOGY ASSOCIATES
Doing business as
Jackson Oncology Associates, PLLC Oral Dispense Pharmacy
Practice address
1227 N State St Ste 101
Jackson, MS 39202-2002
Phone
(601) 355-2485
Fax
(601) 353-1463
NPI assigned
Jan 12, 2018
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON ONCOLOGY ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Richard W Griffith
Title
Executive Director
Phone
(601) 974-5578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X MS Primary

Addresses

Primary practice location

1227 N State St Ste 101
Jackson, MS 39202-2002

Mailing address

1227 N State St Ste 101
Jackson, MS 39202-2002
Phone (601) 355-2485

Other names 1

  • JACKSON ONCOLOGY ASSOCIATES, PLLC ORAL DISPENSE PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180221002550 MS Part B Supplier - Pharmacy 2860392735 Practice locations: Jackson, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jackson Oncology Associates PLLC1227 N State St, Jackson, MS 39202-2002(601) 974-5518 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Apr 21, 1994

National Provider Directory

National Provider Directory
Tax ID family
Jackson Oncology Associatespllc7 organizations share this tax ID, including this one
Part of
Jackson Oncology Associatespllc

Other organizations with this tax ID 6

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

Locations

1860 Chadwick Dr
Ste 301
Jackson, MS 39204
Phone (601) 373-4421

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1780192690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 N STATE ST STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022002",
            "telephone_number": "601-355-2485",
            "fax_number": "601-353-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 N STATE ST STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022002",
            "telephone_number": "601-355-2485",
            "fax_number": "601-353-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON ONCOLOGY ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON ONCOLOGY ASSOCIATES",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-974-5578"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON ONCOLOGY ASSOCIATES, PLLC ORAL DISPENSE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACKSON ONCOLOGY ASSOCIATES, PLLC ORAL DISPENSE PHARMACY",
            "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 Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.