NPIMap

Organization Active NPI

Jones Family Medicine Clinic, PLLC

Doing business as JFMC Quitman Medical, LLC

  • Primary Care Clinic/Center
  • Quitman, MS
National Provider Identifier
1821760026
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JONES FAMILY MEDICINE CLINIC, PLLC
Doing business as
JFMC Quitman Medical, LLC
Practice address
111 Main St
Quitman, MS 39355-2119
Phone
(601) 425-0092
Fax
(601) 425-0473
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
JONES FAMILY MEDICINE CLINIC, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Kaye D Jones
Title
Manager
Phone
(601) 425-0092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

111 Main St
Quitman, MS 39355-2119

Mailing address

30 Circle J Dr Ste 1
Laurel, MS 39440-1981
Phone (601) 425-0092

Other identifiers 1

IdentifierTypeStateIssuer
0876882MedicaidMS

Other names 1

  • JFMC Quitman Medical, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050921000315 MS Part B Supplier - Clinic/Group Practice 6406880368 Receives reassigned benefits from 24 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay Springs, MS; Quitman, MS; Laurel, MS; Heidelberg, MS; Ellisville, MS

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
JFMC Ellisville LLC7 organizations share this tax ID, including this one
Part of
JFMC Ellisville LLC

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1821760026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CIRCLE J DR STE 1",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401981",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MAIN ST",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552119",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES FAMILY MEDICINE CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JONES FAMILY MEDICINE CLINIC, PLLC",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-425-0092"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0876882",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JFMC Quitman Medical, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.