MISSISSIPPI STATE DEPARTMENT OF HEALTH (NPI# 1316358914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316358914 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI STATE DEPARTMENT OF HEALTH |
| Other Organization Name | PEARL WIC DISTRIBUTION CENTER |
| Practice Address |
110 Cross Park Dr Suite C Pearl MS 39208-9016 |
| Mailing Address |
570 E Woodrow Wilson Ave Jackson MS 39216-4538 |
| Practice Telephone | 6019390450 |
| Practice Fax Number | 6014205160 |
| Mailing Telephone | 6015767635 |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-16 |
| Authorized Official Name | MR. MITCHELL ADCOCK (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 6015767635 |
| Authorized Official Credential | CAO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Other Name | Type Code |
|---|---|
| Pearl WIC Distribution Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366853004 | Mississippi State Department of Health | Public Health or Welfare | 3276 Lynch St, Jackson, MS 39209-7205 | 2014-05-15 |
| 1952712630 | Mississippi State Department of Health | Public Health or Welfare | 140 W Mill Road, Bude, MS 39630-7036 | 2014-05-15 |
| 1285045955 | Mississippi State Department of Health | Public Health or Welfare | 7547 Highway 11, Carriere, MS 39426-8904 | 2014-05-15 |
| 1972914653 | Mississippi State Department of Health | Public Health or Welfare | 1000 Irene Street, Liberty, MS 39645-5193 | 2014-05-15 |
| 1609287374 | Mississippi State Department of Health | Public Health or Welfare | 1510 Central Ave E, Wiggins, MS 39577-9633 | 2014-05-15 |
| 1275944993 | Mississippi State Department of Health | Public Health or Welfare | 1185a N Frontage Rd, Prentiss, MS 39474-9302 | 2014-05-15 |
| 1366853087 | Mississippi State Department of Health | Public Health or Welfare | 600 S Arrington Ave, Collins, MS 39428-4159 | 2014-05-15 |
| 1396156063 | Mississippi State Department of Health | Public Health or Welfare | 6912 Washington Ave, Ocean Springs, MS 39564-2133 | 2014-05-15 |
| 1043621881 | Mississippi State Department of Health | Public Health or Welfare | 856 Highway 90, Suite A, Bay St Louis, MS 39520-2736 | 2014-05-14 |
| 1437560216 | Mississippi State Department of Health | Public Health or Welfare | 353a Highway 37, Raleigh, MS 39153-6069 | 2014-05-14 |
| Street Address |
110 CROSS PARK DR SUITE C |
| City | PEARL |
| State | MS |
| Zip Code | 39208-9016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299875 | Catherine Leigh Wilson | Nurse Practitioner | 3794 Ms-468, Pearl, MS 39208 | 2020-09-15 |
| 1548896301 | Rochelle Vanity Cork | Nurse Practitioner | 4635 Us-80, Pearl, MS 39208 | 2020-03-12 |
| 1528600343 | Kelsey D Nowell | Physical Therapy Assistant | 3823 Highway 80 East Suite 1100, Pearl, MS 39208 | 2019-10-14 |
| 1740742329 | Jacksonbracey Health Care | Nurse Practitioner | 4490 Us-80, Pearl, MS 39208 | 2019-04-03 |
| 1740637586 | Telehealthone, LLC | Nurse Practitioner | 5760 Hwy 80 East, Pearl, MS 39208 | 2016-05-23 |
| 1003273897 | Xcel Rehab, Inc. | Clinic/Center | 209 Riverwind East, Suite B, Pearl, MS 39208 | 2016-01-25 |
| 1487035044 | Christopher Rogers | Physical Therapy Assistant | 209 B Riverwind East, Pearl, MS 39208 | 2015-06-09 |
| 1417366725 | Pearl River Dental, Pllc | Dentist | 209 Riverwind East Dr, Pearl, MS 39208 | 2014-08-12 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1437589801 | Leo Easley II | Nurse Practitioner | 3794 Hwy 468, Pearl, MS 39208 | 2013-11-20 |
| Find all providers in zip 39208 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407266877 | Mississippi State Department of Health | Public Health or Welfare | 401 Parkway Dr, Pearl, MS 39208-4516 | 2014-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024747 | Second Chance Outreach Learning Center | Public Health or Welfare | 4807 N State St Ste 407, Jackson, MS 39206-4826 | 2020-02-07 |
| 1184152233 | Tier-3 Solutions, Inc. | Public Health or Welfare | 5255 Keele St Ste C, Jackson, MS 39206-4381 | 2017-06-01 |
| 1609262955 | South Mississippi Aids Task Force, Inc. | Public Health or Welfare | 2756 Fernwood Rd, Biloxi, MS 39531-3520 | 2015-04-14 |
| 1750786158 | Mississippi Department Health | Public Health or Welfare | 1141 Bayview Ave Ste 102, Biloxi, MS 39530-1651 | 2014-10-28 |
| 1265843809 | Mississippi State Department | Public Health or Welfare | 209 S Pleasant St, Charleston, MS 38921-2325 | 2014-05-16 |
| 1366853004 | Mississippi State Department of Health | Public Health or Welfare | 3276 Lynch St, Jackson, MS 39209-7205 | 2014-05-15 |
| 1952712630 | Mississippi State Department of Health | Public Health or Welfare | 140 W Mill Road, Bude, MS 39630-7036 | 2014-05-15 |
| 1285045955 | Mississippi State Department of Health | Public Health or Welfare | 7547 Highway 11, Carriere, MS 39426-8904 | 2014-05-15 |
| 1972914653 | Mississippi State Department of Health | Public Health or Welfare | 1000 Irene Street, Liberty, MS 39645-5193 | 2014-05-15 |
| 1609287374 | Mississippi State Department of Health | Public Health or Welfare | 1510 Central Ave E, Wiggins, MS 39577-9633 | 2014-05-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MISSISSIPPI STATE DEPARTMENT OF HEALTH.
| 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.