JEFFERSON COMPREHENSIVE HEALTH CENTER, INC. (NPI# 1770756447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770756447 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMPREHENSIVE HEALTH CENTER, INC. |
| Practice Address |
468 Highway 33 Fayette MS 39069-4546 |
| Mailing Address |
Po Box 98 Fayette MS 39069-0098 |
| Practice Telephone | 6017863475 |
| Practice Fax Number | 6017869980 |
| Mailing Telephone | 6017863475 |
| Mailing Fax Number | 6017869980 |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | SHIRLEY A. ELLIS (CEO) |
| Authorized Official Telephone | 6017863475 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON COMPREHENSIVE HEALTH CENTER, INC. |
| 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 | 09015637 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139493 | Jefferson Comprehensive Health Center, Inc. | Nurse Practitioner | 1445 George F West Sr Blvd, Natchez, MS 39120-2557 | 2019-11-19 |
| 1710450580 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 1038 N Union St, Natchez, MS 39120-2875 | 2019-01-04 |
| 1164892634 | Jefferson Comprehensive Health Center, Inc. | Specialist | 170 Sgt Prentiss Dr, Natchez, MS 39120-4737 | 2015-09-28 |
| 1295037372 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 1221 N. Dr. Mlk Jr. Street, Natchez, MS 39120-3157 | 2010-11-23 |
| 1205009966 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 145 Homochitto St, Natchez, MS 39120-3906 | 2008-04-02 |
| 1962517185 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 225 Community Dr, Post Office Box 98, Fayette, MS 39069-0098 | 2006-08-20 |
| Street Address |
468 HIGHWAY 33 |
| City | FAYETTE |
| State | MS |
| Zip Code | 39069-4546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265063135 | Georgene Ferrie | Massage Therapist | 1612 Main St., Fayette, MS 39069 | 2020-01-30 |
| 1942741764 | Prime Health and Wellness | Nurse Practitioner | 300 Shannon Street, Fayette, MS 39069 | 2017-03-13 |
| 1063967768 | P-cares Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 3476 River Road, Box 1055, Fayette, MS 39069 | 2016-08-23 |
| 1669866331 | Kanayo Ugboaja | Contractor | 157 Hicks St, Fayette, MS 39069 | 2015-03-20 |
| 1053666503 | Valerie Michele White | Nurse Practitioner | 225 Community Dr., Fayette, MS 39069 | 2012-07-20 |
| 1265752356 | John Ellis Evans | Family Medicine | 456 River Road, Fayette, MS 39069 | 2010-06-11 |
| 1922271691 | Jefferson Comprehensive Health Center Inc | Clinic/Center | Route 1 Box 266, Fayette, MS 39069 | 2008-04-02 |
| 1225247505 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-22 |
| 1356410229 | Johnny B Bills | Family Medicine | 225 Community Ave, Fayette, MS 39069 | 2006-11-07 |
| 1962583971 | Priscilla Jackson | Nurse Practitioner | 225 Community Drive, Fayette, MS 39069 | 2006-10-17 |
| Find all providers in zip 39069 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922271691 | Jefferson Comprehensive Health Center Inc | Clinic/Center | Route 1 Box 266, Fayette, MS 39069 | 2008-04-02 |
| 1891328480 | Jefferson Comprehensive Health Center Inc | Clinic/Center | 405 Main St, Fayette, MS 39069-5576 | 2020-02-21 |
| 1962517185 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 225 Community Dr, Post Office Box 98, Fayette, MS 39069-0098 | 2006-08-20 |
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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 |
| 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.