FNU SAMRA MARIYAM
NPI 1194517714
Pathology - Anatomic Pathology & Clinical Pathology in Jackson, MS

Q: What is Fnu Samra Mariyam's NPI number?

The NPI number for Fnu Samra Mariyam is 1194517714. It was assigned to this individual provider in the NPPES registry on May 20, 2025.

Q: What is Fnu Samra Mariyam's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Q: When was this NPI record last updated?

The NPPES record for Fnu Samra Mariyam was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since May 20, 2025

2500 NORTH STATE STREET, DEPARTMENT OF PATHOLOGY, JACKSON, MS 39216(601) 984-1879 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 4, 2025, May 20, 2025 (2 updates tracked since 2025).

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About Fnu Samra Mariyam NPPES

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

FNU SAMRA MARIYAM (NPI 1194517714) is an individual anatomic pathology & clinical pathology provider in Jackson, Mississippi, licensed in Mississippi (T-5961) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1194517714

Entity TypeIndividualFemale

Primary Taxonomy207ZP0102X

Provider Legal NameFNU SAMRA MARIYAM

Location Address2500 NORTH STATE STREET, DEPARTMENT OF PATHOLOGYJackson, MS 39216

Mailing Address2500 North State Street, Department Of PathologyJackson, MS 39216 · (601) 984-1879

Phone(601) 984-1879

Sole ProprietorNo

Enumeration DateMay 20, 2025

Last NPPES UpdateDecember 4, 20252 updates tracked since enumeration

NPPES CertifiedDecember 4, 2025

✔ NPI 1194517714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

License✔ Licensed in MS · T-5961

Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2500 NORTH STATE STREET, Jackson, MS 39216

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Other Providers at the Same Location NPPES 20

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

MR. BRADFORD STEELE MARTIN FNP-C

Nurse Practitioner

2500 NORTH STATE STREET, DEPARTMENT OF ORTHOPEDICS
JACKSON, MS 39216

Hinds County (601) 815-3045

EMILY BRUMFIELD NP

Nurse Practitioner (Critical Care Medicine)

2500 NORTH STATE STREET
JACKSON, MS 39216

Hinds County (601) 984-5500

KIMBERLY C. COVINGTON TARVER MD

Internal Medicine (Geriatric Medicine)

2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/DIVISION OF GERIATRICS
JACKSON, MS 39216

Hinds County (601) 984-6426

MR. MARCELO EDUARDO RAINS M.D.

Pediatrics

2500 NORTH STATE STREET, UMMC NEONATOLOGY
JACKSON, MS 39216

Hinds County (601) 984-1000

DR. CELSO E. GOMEZ-SANCHEZ MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF ENDOCRINOLOGY
JACKSON, MS 39216

Hinds County (601) 984-5525

MS. CHANDRA ANITA BOSTON C.F.P.M.H.N.P.

Nurse Practitioner (Psychiatric/Mental Health)

2500 NORTH STATE STREET
JACKSON, MS 39216

Hinds County (601) 815-4128

DR. KENNETH R. BENNETT MD

Internal Medicine (Cardiovascular Disease)

2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF CARDIOLOGY
JACKSON, MS 39216

Hinds County (601) 984-5678

DR. GUY DOUGLAS CAMPBELL MD

Internal Medicine (Pulmonary Disease)

2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/DIVISION OF PULMONARY
JACKSON, MS 39216

Hinds County (601) 984-5650

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 Fnu Samra Mariyam's NPI number?

The NPI number for Fnu Samra Mariyam is 1194517714. It was assigned to this individual provider in the NPPES registry on May 20, 2025.

Where is Fnu Samra Mariyam located?

Fnu Samra Mariyam practices at 2500 North State Street Department Of Pathology, Jackson, MS 39216. The listed phone number is (601) 984-1879.

What is Fnu Samra Mariyam's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

When was this NPI record last updated?

The NPPES record for Fnu Samra Mariyam was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.