STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
NPI 1184765372
Dentist in Jackson, MS
About State Of Mississippi - University Of Mississippi Medical Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER (NPI 1184765372), doing business as University Dentists, is a healthcare organization registered as a dentist in Jackson, Mississippi and active in the NPI registry since February 2007. The organization lists Stacy Clardy, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
State Of Mississippi - University Of Mississippi Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
1,923Medicare enrollment records show 1,923 clinicians reassign Medicare billing to State Of Mississippi - University Of Mississippi Medical Center, which bills Medicare for the services they deliver. Of these, 922 practice at this address and 1,230 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 67
Nearest to this location (20)
See all 1,923Jackson, MS 39216
Jackson, MS 39216
Jackson, MS 39216
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is State Of Mississippi - University Of Mississippi Medical Center's NPI number?
The NPI number for State Of Mississippi - University Of Mississippi Medical Center is 1184765372. It was assigned to this organization in the NPPES registry on February 9, 2007. The provider is doing business as University Dentists.
Where is State Of Mississippi - University Of Mississippi Medical Center located?
State Of Mississippi - University Of Mississippi Medical Center is located at 2500 N State St, Jackson, MS 39216. The listed phone number is (601) 984-4699.
What is State Of Mississippi - University Of Mississippi Medical Center's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is State Of Mississippi - University Of Mississippi Medical Center enrolled in Medicare?
Yes. State Of Mississippi - University Of Mississippi Medical Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through State Of Mississippi - University Of Mississippi Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 1,923 clinicians in 67 Medicare specialties reassign their Medicare billing to State Of Mississippi - University Of Mississippi Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (427), Pediatric Medicine (204) and Certified Registered Nurse Anesthetist (CRNA) (155). Of these, 922 practice at this address and 1,230 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does State Of Mississippi - University Of Mississippi Medical Center accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list State Of Mississippi - University Of Mississippi Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for State Of Mississippi - University Of Mississippi Medical Center was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# State Of Mississippi - University Of Mississippi Medical Center · NPI 1184765372
Dentist organization in Jackson, Mississippi. Organization record, active in the CMS NPPES registry since February 9, 2007.
## Identity
- **NPI:** 1184765372 (Entity type: Organization)
- **Enumerated:** February 9, 2007
- **Primary specialty:** Dentist · taxonomy 122300000X
- **Also known as:** University Dentists (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Stacy Clardy, PRACTICE MANAGER
## Practice location
- **Address:** 2500 N STATE ST, Jackson, MS 39216-4500
- **Phone:** (601) 984-4699 · **Fax:** (601) 815-6137
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1,923 clinicians in 67 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (427), Pediatric Medicine (204), Certified Registered Nurse Anesthetist (CRNA) (155); 922 practice at this address and 1,230 within 10 miles; [full list](https://npiprofile.com/npi/1184765372/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 3, 2025
- **Other identifiers:** Medicaid 009014021 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1184765372) · Data from the CMS NPPES public registry.