Active NPI
State Veterans Affairs Board
- Skilled Nursing Facility
- Jackson, MS
National Provider Identifier
1962999789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- STATE VETERANS AFFAIRS BOARD
- Practice address
- 4607 Lindbergh Dr
Jackson, MS 39209-3855 - Phone
- (601) 353-6142
- NPI assigned
- Apr 17, 2018
- Last updated
- Nov 10, 2022
- Organization subpart
- Yes
- Parent organization
- STATE VETERANS AFFAIRS BOARD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Veleka Grady, PHARM.D
- Title
- Pharmacist
- Phone
- (601) 353-6142
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary | ||
| Institutional Pharmacy | 3336I0012X |
Addresses
Primary practice location
4607 Lindbergh Dr
Jackson, MS 39209-3855
Mailing address
4607 Lindbergh Dr
Jackson, MS 39209-3855
National Provider Directory
National Provider Directory- Tax ID family
- Ms State VA Nursing Hom
- Part of
- Ms State VA Nursing Hom
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Collins, MS
- NPI 1235611765
-
- Skilled Nursing Facility
- Kosciusko, MS
- NPI 1295220598
-
- Skilled Nursing Facility
- Biloxi, MS
- NPI 1689489940
Locations
4607 Lindbergh Dr
Jackson, MS 39209
Phone (601) 353-9934
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Skilled Nursing Facility
- Jackson, MS
- NPI 1982811642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1668038400000",
"number": "1962999789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4607 LINDBERGH DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392093855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4607 LINDBERGH DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392093855",
"telephone_number": "601-353-6142"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE VETERANS AFFAIRS BOARD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STATE VETERANS AFFAIRS BOARD",
"enumeration_date": "2018-04-17",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A",
"authorized_official_last_name": "GRADY",
"authorized_official_first_name": "VELEKA",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "601-353-6142",
"authorized_official_credential": "PHARM.D"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336I0012X",
"taxonomy_group": "",
"desc": "Pharmacy, Institutional Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
- State of Mississippi-University of Mississippi Medical Center (University of Mississippi Medical Center)
- State of Mississippi-University of Mississippi Medical Center, Hospita (University of Miss Medical)
- State of Mississippi-University of Ms Medical Center
- State of Ms - University of Ms Medical Center (University Physicians, PLLC)
- State of Ms Umc Newborn Transport
- State Veterans Affairs Board
- Lydia M. Staten, LCSW
- Desiree States, CSS
- Statewide Healthcare Services (Oxford Healthcare)
- Statewide Healthcare Services, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.