MALL SERVICES, LLC (NPI# 1548539117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548539117 |
| Entity Type | Organization |
| Organization Name | MALL SERVICES, LLC |
| Other Organization Name | MEDICAL MALL HEALTH SERVICES AT CMMC |
| Practice Address |
1860 Chadwick Dr Suite 305 Jackson MS 39204-3463 |
| Mailing Address |
350 W Woodrow Wilson Ave Suite 615 Jackson MS 39213-7681 |
| Practice Telephone | 6015034960 |
| Practice Fax Number | 6019820459 |
| Mailing Telephone | 6019820673 |
| Mailing Fax Number | 6019820459 |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2011-12-27 |
| Authorized Official Name | DR. AARON SHIRLEY (PROJECT DIRECTOR) |
| Authorized Official Telephone | 6019820673 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
10119 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08406271 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Mall Health Services at CMMC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699005983 | Mall Services, LLC | Family Medicine | 386 Raymond Rd, Building 30, Jackson, MS 39204-3700 | 2010-01-08 |
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1841456472 | Mall Services, LLC | Clinic/Center | 1066 Wiggins Road, Jackson, MS 39209 | 2008-08-04 |
| 1245477165 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2009-01-14 |
| 1063659340 | Mall Services, LLC | Community Health Worker | 809 N State St, Jackson, MS 39202-2604 | 2009-01-08 |
| 1881878577 | Mall Services, LLC | Clinic/Center | 833 Maple St, Jackson, MS 39203-3844 | 2007-12-18 |
| 1285700617 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2006-11-28 |
| Street Address |
1860 CHADWICK DR SUITE 305 |
| City | JACKSON |
| State | MS |
| Zip Code | 39204-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891792842 | Eric L Rushing | Radiology | 1860 Chadwick Dr, Suite B, Jackson, MS 39204-3463 | 2005-07-06 |
| 1750735452 | Connie Williams | Nurse Practitioner | 1860 Chadwick Dr, Suite 256, Jackson, MS 39204-3463 | 2016-04-19 |
| 1346634888 | Dawn Taylor Joiner | Nurse Practitioner | 1860 Chadwick Dr, Jackson, MS 39204-3463 | 2015-03-23 |
| 1295125813 | Jennifer Easley | Nurse Practitioner | 1860 Chadwick Dr, Suite 205, Jackson, MS 39204-3463 | 2015-02-03 |
| 1689077919 | Anna Cline | Counselor | 1860 Chadwick Dr, Suite 305, Jackson, MS 39204-3463 | 2014-10-01 |
| 1659618106 | Central Mississippi Civic Improvement Association, Inc. | Community Health Worker | 1860 Chadwick Dr, Jackson, MS 39204-3463 | 2013-01-03 |
| 1902140635 | Cardiovascular Institute of Mississippi, LLC | Internal Medicine | 1860 Chadwick Dr, Suite 256, Jackson, MS 39204-3463 | 2012-11-19 |
| 1811244593 | Megan Egbert Slade | Nurse Practitioner | 1860 Chadwick Dr, Suite 256, Jackson, MS 39204-3463 | 2012-08-13 |
| 1437416351 | Vicksburg Hma Physician Management LLC | Family Medicine | 1860 Chadwick Dr, Jackson, MS 39204-3463 | 2012-04-17 |
| 1316238926 | Trinity Pediatric Clinic | Clinic/Center | 1860 Chadwick Dr, Suite 205, Jackson, MS 39204-3463 | 2011-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114471570 | Telemedicine Services of Mississippi | Clinic/Center | 2355b River Oaks Blvd, Jackson, MS 39211-3015 | 2016-08-15 |
| 1851706188 | Mediscan, LLC | Clinic/Center | 111 N Missouri St, Jackson, MO 63755-1831 | 2014-06-25 |
| 1245643204 | Meredith Figueroa | Clinic/Center | 20 Copper Ridge Cv, Jackson, TN 38305-5725 | 2014-06-07 |
| 1710260310 | Envision Eye Care, Inc | Clinic/Center | 1100 Jr Lynch St, Suite 5, Jackson, MS 39203-3311 | 2011-09-21 |
| 1962638791 | Choices for Children and Family - Forest Hill | Clinic/Center | 2607 Raymond Rd, Jackson, MS 39212-2252 | 2009-06-08 |
| 1083778617 | Choices for Children LLC | Clinic/Center | 2941 Terry Rd Ste 22, Jackson, MS 39212-3072 | 2006-12-20 |
| 1255719068 | Medical Care Alliance LLC | Clinic/Center | 5903 Ridgewood Rd, Suite 310, Jackson, MS 39211-3700 | 2015-05-13 |
| 1528470630 | Rebecca A. Griggs | Clinic/Center | 21 Security Dr, Jackson, TN 38305-3626 | 2014-05-22 |
| 1679843452 | Medical Mall Services of Mississippi, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2012-01-10 |
| 1588964811 | Good Samaritan Family Walk-in Clinic, LLC | Clinic/Center | 1869 Highway 45 Byp, Suite 4, Jackson, TN 38305-2464 | 2010-11-03 |
| 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.