MID JACKSON FAMILY HEALTH CLINIC (NPI# 1043503832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043503832 |
| Entity Type | Organization |
| Organization Name | MID JACKSON FAMILY HEALTH CLINIC |
| Practice Address |
514c Woodrow Wilson Dr Jackson MS 39216 |
| Mailing Address |
514c East Woodrow Wilson Ave C Jackson MS 39216 |
| Practice Telephone | 6019817198 |
| Mailing Telephone | 6019817198 |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |
| Authorized Official Name | GLORIA O AREGHAN (PRESIDENT) |
| Authorized Official Telephone | 6019817198 |
| Authorized Official Credential | PHD,CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R831972 | MS | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952693848 | Mid Jackson Family Health Clinic | Early Intervention Provider Agency | 514 E Woodrow Wilson Ave # C, Jackson, MS 39216-4538 | 2011-05-10 |
| Street Address |
514C WOODROW WILSON DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1114427507 | Advance Care, LLC | Clinic/Center | 14 Northtown Dr Ste 105, Jackson, MS 39211-3018 | 2018-02-13 |
| 1467841742 | Dc Medical Services Inc | Clinic/Center | 7 Stonebridge Blvd Ste C, Jackson, TN 38305-2049 | 2015-01-09 |
| 1558779728 | Rural Health Group, Inc. | Clinic/Center | 9742 Nc Highway 305, Jackson, NC 27845-9799 | 2014-07-31 |
| 1043573199 | Fondren Medical Clinic | Clinic/Center | 4436 N State St, Suite A-1, Jackson, MS 39206-5334 | 2012-06-22 |
| 1053646190 | More Convenient Care Center LLC | Clinic/Center | 4612 Medgar Evers Blvd, Suite 10, Jackson, MS 39213-5205 | 2009-10-07 |
| 1518121326 | University Nursing Associates Pllc | Clinic/Center | 136 W Ash St, Jackson, MS 39202-2217 | 2008-07-11 |
| 1114194347 | Community Action Committee of Pike County | Clinic/Center | 14590 St Rt 93, Family Health Center Jackson, Jackson, OH 45640 | 2008-05-16 |
| 1407968738 | Minor Med Care, P.a. | Clinic/Center | 2860 Mcdowell Road Ext, Jackson, MS 39204-4238 | 2006-08-31 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.