CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION (NPI# 1235167891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235167891 |
| Entity Type | Organization |
| Organization Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION |
| Other Organization Name | JACKSON HINDS COMPREHENSIVE HEALTH CNETER |
| Practice Address |
500 W County Line Rd Tougaloo MS 39174-9700 |
| Mailing Address |
3502 W Northside Dr Jackson MS 39213-4454 |
| Practice Telephone | 6019783095 |
| Practice Fax Number | 6019783938 |
| Mailing Telephone | 6013625321 |
| Mailing Fax Number | 6013642600 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2007-09-20 |
| Authorized Official Name | DR. JASMIN CHAPMAN (CEO) |
| Authorized Official Telephone | 6013625321 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09016118 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson Hinds Comprehensive Health Cneter | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376732313 | Central Mississippi Civic Improvement Association | Clinic/Center | 1716 Isable St, Jackson, MS 39204-2352 | 2007-10-16 |
| 1447448667 | Central Mississippi Civic Improvement Association | Clinic/Center | 2185 Fortune St, Jackson, MS 39204-2333 | 2007-10-12 |
| 1205868593 | Central Mississippi Civic Improvement Association | Clinic/Center | 3312 Oak St, Vicksburg, MS 39180-5042 | 2006-07-07 |
| 1770515058 | Central Mississippi Civic Improvement Association | Clinic/Center | 550 Caldwell Drive, Hazlehurst, MS 39083 | 2006-07-07 |
| 1760414494 | Central Mississippi Civic Improvement Association | Clinic/Center | 9700 I-20 W. Frontage Road, Jackson, MS 39041 | 2006-07-06 |
| 1265464556 | Central Mississippi Civic Improvement Association | Clinic/Center | 3312 Oak St, Vicksburg, MS 39180-5042 | 2006-07-07 |
| 1790717080 | Central Mississippi Civic Improvement Association | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
| 1598797888 | Central Mississippi Civic Improvement Association | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
| Street Address |
500 W COUNTY LINE RD |
| City | TOUGALOO |
| State | MS |
| Zip Code | 39174-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992070825 | Morlyn Russell | Nurse Practitioner | 500 W County Line Rd, Tougaloo, MS 39174-9700 | 2012-03-10 |
| 1982746087 | Central Mississippi Health Services, Inc | Internal Medicine | 500 W County Line Rd, Tougaloo, MS 39174-9700 | 2007-02-13 |
| 1548322951 | V A North | Physical Therapist | 500 W County Line Rd, Tougaloo, MS 39174-9700 | 2006-12-14 |
| 1255412904 | Terrence Duwayne Nickens | Specialist | 500 W County Line Rd, Owens Health and Wellnes Center, Tougaloo, MS 39174-9700 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790921724 | Premier Rehab | Clinic/Center | 500 West Countyline Rd, Tougaloo, MS 39174 | 2008-12-22 |
| 1063048650 | Eppsinstituteforhealthyfamilyandcommunityliving,llc | Case Manager/Care Coordinator | 501 W County Line Rd, Tougaloo, MS 39174-9606 | 2020-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048650 | Eppsinstituteforhealthyfamilyandcommunityliving,llc | Case Manager/Care Coordinator | 501 W County Line Rd, Tougaloo, MS 39174-9606 | 2020-03-16 |
| 1790921724 | Premier Rehab | Clinic/Center | 500 West Countyline Rd, Tougaloo, MS 39174 | 2008-12-22 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
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| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
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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.