STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI# 1194738393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194738393 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER |
| Other Organization Name | HOLMES FAMILY MEDICAL CLINIC |
| Practice Address |
18295 Emory Road West MS 39192-0000 |
| Mailing Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6628341321 |
| Practice Fax Number | 6018156301 |
| Mailing Telephone | 6628341321 |
| Mailing Fax Number | 6018156301 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-05-08 |
| Authorized Official Name | JEFFREY GRIMSLEY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6018158732 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09016279 | 05 |
| Other Name | Type Code |
|---|---|
| Holmes Family Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563527 | State of Mississippi - University of Mississippi Medical Center | Prosthetic/Orthotic Supplier | 1410 E Woodrow Wilson Ave Ste I, Jackson, MS 39216-5114 | 2019-08-12 |
| 1477563427 | State of Mississippi - University of Mississippi Medical Center | General Acute Care Hospital | 239 Bowling Green Road, Lexington, MS 39095 | 2006-08-09 |
| 1700872173 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 239 Bowling Green Rd, Lexington, MS 39095-5167 | 2005-09-21 |
| 1003431602 | State of Mississippi - University of Mississippi Medical Center | Medicare Defined Swing Bed Unit | 960 Avent Dr, Grenada, MS 38901-5230 | 2020-06-10 |
| 1821525957 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 1300 Sunset Dr Ste F, Grenada, MS 38901-4083 | 2017-05-19 |
| 1528595667 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 418b N Applegate St, Winona, MS 38967-1827 | 2017-05-19 |
| 1255883690 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jmm Suite 2525, Jackson, MS 39216-4500 | 2016-11-02 |
| 1376969030 | State of Mississippi - University of Mississippi Medical Center | Clinic/Center | 2500 N State St, Jackson, MS 39216-4500 | 2014-03-05 |
| 1972759132 | State of Mississippi - University of Mississippi Medical Center | Nurse Anesthetist, Certified Registered | 2500 N State St, Jackson, MS 39216-4500 | 2008-08-07 |
| 1972759140 | State of Mississippi - University of Mississippi Medical Center | Dietitian, Registered | 2500 N State St, Jackson, MS 39216-4500 | 2008-08-07 |
| Street Address |
18295 EMORY ROAD |
| City | WEST |
| State | MS |
| Zip Code | 39192-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023668365 | Terri Lynn Armstrong | Technician | 9174 Attala Rd 3225, West, MS 39192 | 2019-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396586 | Stacey Lynne Ready | Nurse Practitioner | 200 Uptmore Rd, West, TX 76691-2339 | 2020-11-08 |
| 1023668365 | Terri Lynn Armstrong | Technician | 9174 Attala Rd 3225, West, MS 39192 | 2019-09-18 |
| 1811455462 | Brent P Komlofske | Specialist/Technologist | 1008 Jerry Mashek Dr, West, TX 76691-1866 | 2019-03-03 |
| 1760963375 | Terri Shelton | Occupational Therapy Assistant | 300 W Haven St, West, TX 76691-1011 | 2018-08-22 |
| 1720567308 | Paula Brown | Home Health | 531 Wiggins Rd, West, TX 76691-1962 | 2018-08-14 |
| 1710489216 | Jill Anne Davis | Specialist/Technologist | 290 Bolton Cir, West, TX 76691-2286 | 2018-03-01 |
| 1316447139 | Jill Rea Jenkins | Licensed Vocational Nurse | 20606 N Ih 35, West, TX 76691-1812 | 2018-02-19 |
| 1750881488 | Jennifer Michele Wilson | Licensed Vocational Nurse | 20606 N Interstate 35, West, TX 76691-1812 | 2018-02-19 |
| 1851899520 | Ann Marie Dennis | Counselor | 2634 Jerry Mashek Dr, West, TX 76691-1821 | 2018-01-29 |
| 1730698150 | Kristin A Immicke | Speech-Language Pathologist | 1414 Jane Ln, West, TX 76691-1012 | 2017-09-28 |
| Find all providers in WEST | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
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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.