Active NPI
Children'S Psychiatric Clinic
- Child & Adolescent Psychiatry Physician
- Flowood, MS
National Provider Identifier
1891136818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- Legal business name
- CHILDREN'S PSYCHIATRIC CLINIC
- Practice address
- 3531 Lakeland Dr Ste 1052
Flowood, MS 39232-8016 - Phone
- (601) 829-4170
- NPI assigned
- Jul 8, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John E Wilkaitis, M.D.
- Title
- Owner
- Phone
- (601) 829-4170
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | Primary |
Addresses
Primary practice location
3531 Lakeland Dr Ste 1052
Flowood, MS 39232-8016
Mailing address
3531 Lakeland Dr Ste 1052
Flowood, MS 39232-8016
Phone (601) 982-8531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03932074 | Medicaid | MS |
National Provider Directory
National Provider Directory- Tax ID family
- Children'S Psychiatric Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adolescent and Children Mental Health Clinic/Center
- Jackson, MS
- NPI 1518411529
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Jackson, MS
- NPI 1154360824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721692800000",
"number": "1891136818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3531 LAKELAND DR STE 1052",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392328016",
"telephone_number": "601-982-8531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3531 LAKELAND DR STE 1052",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392328016",
"telephone_number": "601-829-4170"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDREN'S PSYCHIATRIC CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-08",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A",
"authorized_official_last_name": "WILKAITIS",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "601-829-4170",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03932074",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flowood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.