State of Mississippi - University of Mississippi Medical Center

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-4367

NPI assigned

Nov 9, 2021

Last updated

Nov 9, 2021By 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

Jeffrey Grimsley

Title

Cfo

Phone

(601) 815-8732

Specialties & licenses 1

Addresses

Other names 1

• Children's Transport UMMC Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• State of Mississippi-University of Mississippi Medical Center

  dba UMMC Grenada Ambulance Service

  • Ambulance
  • Grenada, MS
  • NPI 1780015396

  O20140305001962

  Same enrollment

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1871259481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DRIVE",
            "address_2": "CBO-SUITE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "39056",
            "telephone_number": "601-815-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "GRIMSLEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-815-8732"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Transport UMMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• State of Mississippi - University of Mississippi Medical Center
• State of Mississippi - University of Mississippi Medical Center
• State of Mississippi - University of Mississippi Medical Center (UMHC Care Clinic Pharmacy)
• State of Mississippi - University of Mississippi Medical Center
• State of Mississippi - University of Mississippi Medical Center
• State of Mississippi - University of Mississippi Medical Center (University Ms Medical Center)
• State of Mississippi - University of Mississippi Medical Center (University Ms Medical Center)
• State of Mississippi University of Mississippi Medical Center (University Hospital & Clinic HTC Pharmacy)
• State of Mississippi- University of Mississippi Medical Center (UMC Medical Mall)
• State of Mississippi- University of Mississippi Medical Center (Midtown Mobile Clinic)

• Ambulance in Jackson, MS
• Providers in Jackson, MS by specialty
• Ambulance in Mississippi

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.