CENTRAL JACKSON FAMILY MEDICAL CLINIC – NPI #1154549707
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CENTRAL JACKSON FAMILY MEDICAL CLINIC is an AHC clinic located in JACKSON, MS. NPPES has assigned the NPI number 1154549707 to CENTRAL JACKSON FAMILY MEDICAL CLINIC on April 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

The NPI profile was previously updated about 16 years ago on Dec 09, 2010. 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 CENTRAL JACKSON FAMILY MEDICAL CLINIC below.

NPI Profile for
CENTRAL JACKSON FAMILY MEDICAL CLINIC

NPI Number
1154549707
Enumeration Date

(more than 19 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
CENTRAL JACKSON FAMILY MEDICAL CLINIC
Primary location
514 C WOODROW WILSON
JACKSON, MS 39216
Phone: (601) 981-7198 Fax: (601) 981-6616
Mailing address
P.O. BOX 4610
JACKSON, MS 39296-4610
Phone: (601) 981-7198 Fax: (601) 981-6616
Organization Subpart
No
Authorized Official
CASSANDRA THOMAS
PHYSICAIN
Phone: (601) 981-7198
Updated
Identifiers

Identifiers for CENTRAL JACKSON FAMILY MEDICAL CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS00112137
MEDICAIDMS00937242
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
261QM2500X
- Clinic/Center / Medical Specialty (Primary)
MS 18905

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.