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SONNY MONTGOMERY V A M EDICAL CENTER NPI 1013014695


NPI Information

NPI: 1013014695
Provider Name: SONNY MONTGOMERY V A M EDICAL CENTER
Classification: Chronic Disease Hospital - 281P00000X
Entity Type: Organization
Address:
1500 E WOODROW WILSON AVE
JACKSON, MS
ZIP 39216
Phone: (601) 362-4471
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SONNY MONTGOMERY V A M EDICAL CENTER is a chronic disease hospital in Jackson, MS. The provider is (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes. SONNY MONTGOMERY V A M EDICAL CENTER NPI is 1013014695. The provider is registered as an organization entity type.

The provider's business location address is:

1500 E WOODROW WILSON AVE
JACKSON, MS
ZIP 39216-116
Phone: (601) 362-4471

The provider's authorized official is Linda Ruth Mack .
The authorized official title is Certified Nurse Practitioner and has the following contact phone number (601) 362-4471.

The enumeration date for this NPI number is 9/17/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1281P00000XChronic Disease HospitalR725005MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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