HMG GROUP LLC NPI 1255738035

NPI Information

  • NPI: 1255738035
  • Provider Name: HMG GROUP LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: FONDREN CARE CLINIC
  • Address: 4436 N STATE ST
    SUITE A1
    JACKSON, MS
    ZIP 39206
  • Phone: (601) 383-2036

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NPI Details

HMG GROUP LLC is a family medicine in Jackson, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HMG GROUP LLC NPI is 1255738035. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Fondren Care Clinic.

The provider's business location address is:

4436 N STATE ST
SUITE A1
JACKSON, MS
ZIP 39206-334
Phone: (601) 383-2036
Fax: (601) 981-5819

The provider's authorized official is Johnathan Chad Gibson .
The authorized official title is Office Manager and has the following contact phone number (601) 951-9197.

The enumeration date for this NPI number is 11/22/2014 and was last updated on 11/22/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthR860365MISSISSIPPINo
2363LF0000XNurse PractitionerFamilyR878138MISSISSIPPINo
3363LW0102XNurse PractitionerWomen's HealthR860365MISSISSIPPINo
4207Q00000XFamily Medicine07980MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
104136595MEDICAIDMISSISSIPPI
2080004336MEDICARE PINMISSISSIPPI
3D73529MEDICARE UPINMISSISSIPPI
403727355MEDICAIDMISSISSIPPI
504457077MEDICAIDMISSISSIPPI

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: 11/21/2025

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