CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION (NPI# 1790717080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790717080 |
| Entity Type | Organization |
| Organization Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION |
| Other Organization Name | JACKSON HINDS COMPREHENSIVE HEALTH CENTER |
| Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
| Practice Telephone | 6013625321 |
| Mailing Telephone | 6013625321 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-04-25 |
| Authorized Official Name | DR. JASMIN CHAPMAN (CEO) |
| Authorized Official Telephone | 6013625321 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09013452 | 05 |
| Other Name | Type Code |
|---|---|
| JACKSON HINDS COMPREHENSIVE HEALTH CENTER | 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 |
| 1235167891 | Central Mississippi Civic Improvement Association | Clinic/Center | 500 W County Line Rd, Tougaloo, MS 39174-9700 | 2006-06-30 |
| 1265464556 | Central Mississippi Civic Improvement Association | Clinic/Center | 3312 Oak St, Vicksburg, MS 39180-5042 | 2006-07-07 |
| 1598797888 | Central Mississippi Civic Improvement Association | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2006-07-07 |
| Street Address |
3502 W NORTHSIDE DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
| 1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
| 1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
| 1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
| 1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
| 1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
| 1356810360 | Thrishanna Clark | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-11-19 |
| 1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
| 1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
| 1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417572595 | Southern Ohio Mini Dental Implant Center | Clinic/Center | 41 E South St, Jackson, OH 45640-1638 | 2020-06-15 |
| 1619503349 | Alpine Denitstry | Clinic/Center | 945 W Broadway Ave Apt 201, Jackson, WY 83001-8217 | 2020-03-13 |
| 1790269173 | Chad Brown, D.d.s., P.C. | Clinic/Center | 604 2nd St, Jackson, MN 56143-1646 | 2018-09-20 |
| 1972863207 | Bingham Endodontics, Pllc | Clinic/Center | 610 W. Broadway Ave, Jackson, WY 83001 | 2012-05-21 |
| 1396903811 | John W. Crowder, D.d.s.,p.c. | Clinic/Center | 209 Oil Well Rd, Jackson, TN 38305-7924 | 2008-05-30 |
| 1194997775 | Noel K. Toler,jr.,d.d.s.,p.a. | Clinic/Center | 2600 River Ridge Dr, Jackson, MS 39216-5013 | 2008-03-24 |
| 1124182407 | Choices for Dental | Clinic/Center | 2941 Terry Rd Ste 16, Jackson, MS 39212-3072 | 2006-12-20 |
| 1982787073 | G. Robert Hopper, D.d.s., P.C. | Clinic/Center | 468 N Parkway, Jackson, TN 38305-2857 | 2006-10-23 |
| 1508958133 | Mid South Dental Center of Jackson | Clinic/Center | 5685 Hwy 18 West, Jackson, MS 39209 | 2006-09-29 |
| 1225642242 | Lifetime Dental Care Pllc | Clinic/Center | 2528 Spring Arbor Rd, Jackson, MI 49203-3602 | 2020-09-08 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION.
| 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.