NPIMap

Organization Active NPI

State Veterans Affairs Board

  • Skilled Nursing Facility
  • Jackson, MS
National Provider Identifier
1982811642
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STATE VETERANS AFFAIRS BOARD
Practice address
660 North St
Jackson, MS 39202-3141
Phone
(601) 576-4859
Fax
(601) 576-4868
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Demetrice Watts
Title
Cfo
Phone
(601) 576-4859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

660 North St
Jackson, MS 39202-3141

Mailing address

PO Box 3439
Jackson, MS 39207-3439
Phone (601) 576-4859

Other practice location 1

3466 Highway 80 E
Pearl, MS 39208-4001
Phone (601) 576-4864

Other names 1

  • MS State Veterans Affairs Board Other name

National Provider Directory

National Provider Directory

Locations

660 North St
Jackson, MS 39202
Phone (601) 576-4859

3466 Highway 80 E
Pearl, MS 39208
Phone (601) 576-4864

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1982811642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392073439",
            "telephone_number": "601-576-4859",
            "fax_number": "601-576-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 NORTH ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023141",
            "telephone_number": "601-576-4859",
            "fax_number": "601-576-4868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3466 Highway 80 E",
            "address_purpose": "LOCATION",
            "city": "Pearl",
            "state": "MS",
            "postal_code": "392084001",
            "country_code": "US",
            "telephone_number": "601-576-4864",
            "fax_number": "601-576-4868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATE VETERANS AFFAIRS BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "DEMETRICE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-576-4859"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MS State Veterans Affairs Board",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 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.

Verify at the official NPI Registry.