JEFFERSON COMPREHENSIVE HEALTH CENTER INC (NPI# 1891328480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891328480 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMPREHENSIVE HEALTH CENTER INC |
| Practice Address |
405 Main St Fayette MS 39069-5576 |
| Mailing Address |
Po Box 98 Fayette MS 39069-0098 |
| Practice Telephone | 6017863475 |
| Practice Fax Number | 6017866320 |
| Mailing Telephone | 6017863475 |
| Mailing Fax Number | 6017866320 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | SHIRLEY ELLIS-STAMPLEY (CEO) |
| Authorized Official Telephone | 6017863475 |
| 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 |
| Other Name | Type Code |
|---|---|
| Jefferson Comprehensive Health Center, Inc. Medical/Dental Mobile Unit | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922271691 | Jefferson Comprehensive Health Center Inc | Clinic/Center | Route 1 Box 266, Fayette, MS 39069 | 2008-04-02 |
| Street Address |
405 MAIN ST |
| City | FAYETTE |
| State | MS |
| Zip Code | 39069-5576 |
| 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 |
|---|---|---|---|---|
| 1770756447 | Jefferson Comprehensive Health Center, Inc. | Clinic/Center | 468 Highway 33, Fayette, MS 39069-4546 | 2008-04-02 |
| 1922271691 | Jefferson Comprehensive Health Center Inc | Clinic/Center | Route 1 Box 266, Fayette, MS 39069 | 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 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 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 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 | ||||
Please comment or provide details below to improve the information on JEFFERSON COMPREHENSIVE HEALTH CENTER INC.
| 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.