UMC MEDICAL MALL
NPI 1194930693
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Jackson, MS
About Umc Medical Mall NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UMC MEDICAL MALL (NPI 1194930693) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Jackson, Mississippi and active in the NPI registry since May 2007. The organization lists William Kennedy, Associate Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
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)
Umc Medical Mall is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
1,924Medicare enrollment records show 1,924 clinicians reassign Medicare billing to Umc Medical Mall, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 1,220 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 1,924Jackson, MS 39213
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 1194930693. It was assigned to this organization in the NPPES registry on May 10, 2007. The provider is doing business as Umc Medical Mall.
Where is State Of Mississippi- University Of Mississippi Medical Center located?
State Of Mississippi- University Of Mississippi Medical Center is located at 350 W Woodrow Wilson Ave Suite 479, Jackson, MS 39213. The listed phone number is (601) 815-6350.
What is State Of Mississippi- University Of Mississippi Medical Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.
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), 1,924 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, 2 practice at this address and 1,220 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 October 2, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.
# Umc Medical Mall · NPI 1194930693
End-Stage Renal Disease (ESRD) Treatment organization in Jackson, Mississippi. Organization record, active in the CMS NPPES registry since May 10, 2007.
## Identity
- **NPI:** 1194930693 (Entity type: Organization)
- **Enumerated:** May 10, 2007
- **Primary specialty:** Clinic/Center - End-Stage Renal Disease (ESRD) Treatment · taxonomy 261QE0700X
- **Legal business name:** State Of Mississippi- University Of Mississippi Medical Center
- **Organization subpart:** No
- **Authorized official:** William Kennedy, ASSOCIATE ADMINISTRATOR
## Practice location
- **Address:** 350 W WOODROW WILSON AVE, SUITE 479, Jackson, MS 39213-7681
- **Phone:** (601) 815-6350 · **Fax:** (601) 815-6348
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1,924 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); 2 practice at this address and 1,220 within 10 miles; [full list](https://npiprofile.com/npi/1194930693/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 2, 2007
- **Other identifiers:** Medicaid 20256 (MS); Medicare OSCAR/certification 253503
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Source: [NPI Profile](https://npiprofile.com/npi/1194930693) · Data from the CMS NPPES public registry.