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

26050 Highway 12
MC Cool, MS 39108-9160

Phone

(662) 289-9404

Fax

(662) 289-6450

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia J Dean, CFNP

Title

Member Manager

Phone

(662) 289-9404

Specialties & licenses 1

Addresses

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
  • Ethel, MS
  • NPI 1851623664
  NPD tax ID

Locations

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1912933623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5264 ATTALA ROAD 1135",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390906597",
            "telephone_number": "662-289-9404",
            "fax_number": "662-289-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26050 HIGHWAY 12",
            "city": "MC COOL",
            "state": "MS",
            "postal_code": "391089160",
            "telephone_number": "662-289-9404",
            "fax_number": "662-289-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MS SCHOOL BASED HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "662-289-9404",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Baugh
• Hands of Faith Homecare Agency, LLC

• All providers in MC Cool, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.