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STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER NPI 1699857433


NPI Information

NPI: 1699857433
Provider Name: STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
2500 N STATE ST
PFS
JACKSON, MS
ZIP 39216
Phone: (601) 984-4619
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STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER is a nurse practitioner in Jackson, MS. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER NPI is 1699857433. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2500 N STATE ST
PFS
JACKSON, MS
ZIP 39216-500
Phone: (601) 984-4619
Fax: (601) 984-4657

The provider's authorized official is William Kennedy .
The authorized official title is Associate Administor and has the following contact phone number (601) 986-4699.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 4/20/2008.


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
1133V00000XDietitian, RegisteredNo
2367500000XNurse Anesthetist, Certified RegisteredNo
3363L00000XNurse PractitionerYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERMISSISSIPPIBLUE CROSS BLUE SHIELD
2CH5738OTHERMISSISSIPPIRR MEDICARE
3C02587MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI
4=========MOTHERMISSISSIPPIBLUE CROSS BLUE SHIELD
5=========NOTHERMISSISSIPPIBLUE CROSS BLUE SHIELD
609015456MEDICAIDMISSISSIPPI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.