Jefferson Comprehensive Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Fayette, MS
NPI 1962517185 · NPPES record last updated Jun 10, 2026
Key facts
- NPI
- 1962517185
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- JEFFERSON COMPREHENSIVE HEALTH CENTER, INC.
- Practice address
- 405 Main St
Fayette, MS 39069-5576 - Phone
- (601) 786-3475
- Fax
- (601) 786-9980
- NPI assigned
- Aug 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Katrina Thompson
- Title
- Ceo
- Phone
- (601) 786-3475
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 6
Practitioners 11
-
Crystal S Cook, CFNP
-
Priscilla Jackson, CFNP
-
April Layne Mitchell, PMHNP
-
Sharonda Rogers, NURSE PRACTITIONER
-
Lakeitha Hamberlin Turner, FNP-BC
-
Ronald M Frye, MD
-
Nusrat Kabir, MD
-
Jermonique King, NP
-
Kenitra Wallace, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MS
Federally qualified health center certification: CCN 251962
- Legal name
- JEFFERSON COMPREHENSIVE HEALTH CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 26, 2007
- Last certification
- Jan 26, 2007
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 19, 1982 in MS
- Enrollment address
- 145 Homochitto St
Natchez, MS 39120-3906
Federally qualified health center certification: CCN 251813
- Legal name
- JEFFERSON COMPREHENSIVE HEALTH CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 19, 1982 in MS
- Enrollment address
- 405 Main St
Fayette, MS 39069-5576
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Arnell Harried |
Corporate Director |
Jun 1, 2012 | |
| Shirley Smith |
Corporate Director |
Jun 1, 2024 | |
| Corporate Director | Jun 1, 2024 | ||
| James Coleman |
Corporate Director | Jun 1, 2023 | |
| Ella Hudson |
Corporate Director |
Jan 14, 2010 | |
| James Walker |
Corporate Director |
Jan 11, 1996 | |
| Dante Weir |
Corporate Director |
Jun 1, 2024 | |
| Corporate Director | Jun 1, 2024 | ||
| Ari'Yel Williams |
Corporate Director | Aug 1, 2025 | |
| Errol Pierce |
Corporate Director |
Jun 1, 2021 | |
| Corporate Director | Jun 1, 2021 | ||
| Derrick Shelvy |
Corporate Director |
Jun 1, 2019 | |
| Corporate Director | Jun 1, 2001 | ||
| Dakia Cameron |
Corporate Director | Aug 1, 2025 | |
| Monica Lowe |
W-2 Managing Employee |
Jun 1, 2025 | |
| W-2 Managing Employee |
May 31, 2025 | ||
| Regina Reed |
Corporate Director |
Jan 1, 1992 | |
| Faye Brown |
Corporate Director |
Jun 1, 2020 | |
| Corporate Director | Jun 1, 2020 | ||
| Katrina M Collins |
Corporate Officer | Jun 1, 2021 | |
| Corporate Director | Jun 1, 2021 | ||
| W-2 Managing Employee |
Sep 23, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061110000274 | MS | Part a Provider - Federally Qualified Health Center (FQHC) | 0345248100 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Natchez, MS |
| O20100827000274 | MS | Part a Provider - Federally Qualified Health Center (FQHC) | 0345248100 | Practice locations: Fayette, MS |
| O20140416001171 | MS | Part B Supplier - Clinic/Group Practice | 0345248100 |
Receives reassigned benefits from 9 practitioners 5 other NPIs on this enrollment Practice locations: Fayette, MS; Natchez, MS |
National Provider Directory
Locations
101 Cottage Home Dr
Natchez, MS 39120
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | MS | Yes |
Addresses
Primary practice location
405 Main St
Fayette, MS 39069-5576
Mailing address
PO Box 98
Fayette, MS 39069-0098
Phone (601) 786-3475
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09010057 | Medicaid | MS |
Other providers in Fayette, MS
- Priscilla Jackson
- Veronica Mays Jackson
- Jefferson Comprehensive Health Center Inc
- Jefferson Comprehensive Health Center Inc
- Jefferson Comprehensive Health Center, Inc.
- Jefferson County Hospital
- Jefferson County Hospital
- Jefferson County Hospital
- Jefferson County Hospital
- Jefferson County Hospital
All providers in Fayette, MS · Federally Qualified Health Center (FQHC) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.