NPIMap

Organization Active NPI

Jackson Public Schools

Doing business as Jackson Public Schools Poindexter Clinic

  • Student Health Clinic/Center
  • Jackson, MS
National Provider Identifier
1942472899
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
JACKSON PUBLIC SCHOOLS
Doing business as
Jackson Public Schools Poindexter Clinic
Practice address
618 S President St
Jackson, MS 39201-5601
Phone
(601) 960-8705
Fax
(601) 960-8704
NPI assigned
Apr 1, 2008
Last updated
Apr 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Mrs. Tammy D. Crocker, R.N.
Title
Lead Nurse
Phone
(601) 209-4456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

618 S President St
Jackson, MS 39201-5601

Mailing address

618 S President St
Jackson, MS 39201-5601
Phone (601) 960-8705

Other identifiers 1

IdentifierTypeStateIssuer
05154701MedicaidMS

Other names 1

  • Jackson Public Schools Poindexter Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jackson Public School District13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1942472899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S PRESIDENT ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392015601",
            "telephone_number": "601-960-8705",
            "fax_number": "601-960-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S PRESIDENT ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392015601",
            "telephone_number": "601-960-8705",
            "fax_number": "601-960-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PUBLIC SCHOOLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "LEAD NURSE",
        "authorized_official_telephone_number": "601-209-4456",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05154701",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Public Schools Poindexter Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.