JEA SURGICAL, LLC – NPI #1669242822
Clinic/Center

JEA SURGICAL, LLC is an AHC clinic located in MADISON, MS. NPPES has assigned the NPI number 1669242822 to JEA SURGICAL, LLC on January 08, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Jun 13, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JEA SURGICAL, LLC below.

NPI Profile for
JEA SURGICAL, LLC

NPI Number
1669242822
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JEA SURGICAL, LLC
Primary location
1026 BAPTIST CIRCLE
SUITE 101
MADISON, MS 39110
Phone: (601) 353-2020 Fax:
Mailing address
1026 BAPTIST CIR STE 101
MADISON, MS 39110-2028
Phone: (601) 353-2020 Fax: (769) 567-1069
Organization Subpart
No
Authorized Official
SHANE HUMPHRIES
PRACTICE ADMINISTRATOR
Phone: (601) 353-2020
Updated
Certification Date
Jun 13, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
207W00000X
- Ophthalmology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.