Central Ms School Based Health LLC.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R853619 Issued in MS

Legal business name

CENTRAL MS SCHOOL BASED HEALTH LLC.

Practice address

2268 College Street
Ethel, MS 39067

Phone

(662) 674-0198

Fax

(662) 674-0098

NPI assigned

Feb 3, 2010

Last updated

Feb 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia Johnson Dean, CFNP

Title

Provider/Owner

Phone

(662) 674-0198

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Central Ms School Based Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Central Ms School Based Health, LLC

  • Family Nurse Practitioner
  • McCool, MS
  • NPI 1912933623
  NPD tax ID

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1851623664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "ETHEL",
            "state": "MS",
            "postal_code": "390670356",
            "telephone_number": "662-674-0198",
            "fax_number": "662-674-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 COLLEGE STREET",
            "city": "ETHEL",
            "state": "MS",
            "postal_code": "39067",
            "telephone_number": "662-674-0198",
            "fax_number": "662-674-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MS SCHOOL BASED HEALTH LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "662-674-0198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00255854",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Shuler

• Family Nurse Practitioner in Ethel, MS
• Providers in Ethel, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.