NPIMap

Organization Active NPI

Jackson Pain Center PA

  • Pain Medicine (Anesthesiology) Physician
  • Jackson, MS
National Provider Identifier
1962823344
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
10764 Issued in MS
Legal business name
JACKSON PAIN CENTER PA
Practice address
1151 N State St
Suite 311
Jackson, MS 39202-2407
Phone
(601) 355-7246
Fax
(601) 969-1173
NPI assigned
Jan 2, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
John Edwin Dodd, MD
Title
President
Phone
(601) 355-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 10764 MS Primary

Addresses

Primary practice location

1151 N State St
Suite 311
Jackson, MS 39202-2407

Mailing address

1151 N State St
Suite 311
Jackson, MS 39202-2407
Phone (601) 355-7246

National Provider Directory

National Provider Directory

Locations

1151 N State St
Ste 311A
Jackson, MS 39202
Phone (601) 355-7245

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1962823344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-355-7246",
            "fax_number": "601-969-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-355-7246",
            "fax_number": "601-969-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PAIN CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "DODD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-355-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "10764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2014; 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.