NPIMap

Organization Active NPI

Jackson Psychiatry Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1790087393
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
JACKSON PSYCHIATRY GROUP
Practice address
201 Northlake Ave
Ridgeland, MS 39157-1715
Phone
(601) 366-4696
Fax
(601) 414-9486
NPI assigned
Dec 2, 2010
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Mr. Douglas W. Byrd, MDNPI 1477679736
Title
Owner
Phone
(601) 366-4696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

201 Northlake Ave
Ridgeland, MS 39157-1715

Mailing address

201 Northlake Ave
Ridgeland, MS 39157-1715
Phone (601) 366-4696

National Provider Directory

National Provider Directory

Locations

201 Northlake Ave
Ridgeland, MS 39157
Phone (601) 366-4696

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1790087393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NORTHLAKE AVE",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571715",
            "telephone_number": "601-366-4696",
            "fax_number": "601-414-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTHLAKE AVE",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571715",
            "telephone_number": "601-366-4696",
            "fax_number": "601-414-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PSYCHIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-366-4696",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.