SONNY MONTGOMERY V A M EDICAL CENTER
NPI 1013014695
Chronic Disease Hospital in Jackson, MS

Active since September 17, 2006
1500 E WOODROW WILSON AVE, JACKSON, MS 39216(601) 362-4471 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Sonny Montgomery V A M Edical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SONNY MONTGOMERY V A M EDICAL CENTER (NPI 1013014695) is a healthcare organization registered as a chronic disease hospital in Jackson, Mississippi and active in the NPI registry since September 2006. The organization lists Linda Ruth Mack, Certified Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1013014695
Entity TypeOrganization
Primary Taxonomy281P00000X
Legal Business NameSONNY MONTGOMERY V A M EDICAL CENTER
Location Address1500 E WOODROW WILSON AVEJackson, MS 39216-5116
Mailing Address1973 Houston RdBolton, MS 39041-9387 · (601) 866-2429
Organization SubpartNo
Authorized OfficialLinda Ruth MackCertified Nurse Practitioner · (601) 362-4471
Enumeration DateSeptember 17, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1013014695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyChronic Disease HospitalHospitals
Taxonomy Code281P00000X
License Licensed in MS · R725005
Definition

(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes.

1500 E WOODROW WILSON AVE, Jackson, MS 39216

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist (Pharmacotherapy)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Dermatology
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Internal Medicine
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Internal Medicine (Hematology & Oncology)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Psychiatry & Neurology (Psychiatry)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Internal Medicine
1500 E WOODROW WILSON AVE, G.V. (SONNY) MONTGOMERY VAMC (111-P)
JACKSON, MS 39216
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1500 E WOODROW WILSON AVE, R&E BUILDING (151) - VAMC
JACKSON, MS 39216
Psychiatry & Neurology (Psychiatry)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013014695, enumerated as an "organization" on September 17, 2006.

The provider is located at 1500 E WOODROW WILSON AVE JACKSON, MS 39216 and the phone number is (601) 362-4471.

Chronic Disease Hospital with taxonomy code 281P00000X.