Jackson Brace and Limb Company

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

JACKSON BRACE AND LIMB COMPANY

Practice address

1320 N State St
Jackson, MS 39202-2003

Phone

(601) 353-2477

Fax

(601) 355-4100

NPI assigned

Nov 22, 2006

Organization subpart

No

Name

Micki Corley

Title

Office Manager

Phone

(601) 353-2477

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 7, 2025.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1992870950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022096",
            "telephone_number": "601-353-2477",
            "fax_number": "601-355-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022003",
            "telephone_number": "601-353-2477",
            "fax_number": "601-355-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON BRACE AND LIMB COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "CORLEY",
        "authorized_official_first_name": "MICKI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-353-2477"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040095",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000012226",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jackson, MS
• Prosthetic/Orthotic Supplier in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.