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JACKSON VA MEDICAL CENTER
NPI 1285716928
Substance Abuse Rehabilitation Facility in Jackson, MS

Active since October 20, 2006
1500 E WOODROW WILSON AVE, JACKSON, MS 39216(601) 362-4471(601) 364-1298 Get Directions Write a Review

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

About Jackson Va Medical Center NPPES

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

JACKSON VA MEDICAL CENTER (NPI 1285716928) is a healthcare organization registered as a substance abuse rehabilitation facility in Jackson, Mississippi and active in the NPI registry since October 2006. The organization lists Richard J Baltz, Center Director, as its authorized official.

NPPES Registry Identity

NPI1285716928
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameJACKSON VA MEDICAL CENTER
Location Address1500 E WOODROW WILSON AVEJackson, MS 39216-5116
Mailing Address1500 E Woodrow Wilson AveJackson, MS 39216-5116 · (601) 362-4471 · Fax (601) 364-1298
Phone(601) 362-4471
Fax(601) 364-1298
Organization SubpartNo
Authorized OfficialRichard J BaltzCenter Director · (601) 364-1359
Enumeration DateOctober 20, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1285716928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

1500 E WOODROW WILSON AVE, Jackson, MS 39216
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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.

DR. LEAH MICHELLE RUSSELL PHARM.D.
Pharmacist (Pharmacotherapy)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 919-2403
DR. JOSEPH H ROBINSON MD
Dermatology
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 362-4471
DR. ROBERT EMMETT LYNCH II M.D.
Internal Medicine
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 364-7901
DR. TAWFIQ IFTEKHAR KHANSUR M.D
Internal Medicine (Hematology & Oncology)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 364-4471
DR. RAY V KIMBLE MD
Psychiatry & Neurology (Psychiatry)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 362-4471
JO LURESA HARBOUR MD
Internal Medicine
1500 E WOODROW WILSON AVE, G.V. (SONNY) MONTGOMERY VAMC (111-P)
JACKSON, MS 39216
Hinds County (601) 362-4471
DR. JOSE SANTIAGO SUBAUSTE M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1500 E WOODROW WILSON AVE, R&E BUILDING (151) - VAMC
JACKSON, MS 39216
Hinds County (601) 362-4471
DR. GURDIAL S SANDHU M.D.
Psychiatry & Neurology (Psychiatry)
1500 E WOODROW WILSON AVE
JACKSON, MS 39216
Hinds County (601) 362-4471

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 Jackson VA Medical Center's NPI number?

The NPI number for Jackson VA Medical Center is 1285716928. It was assigned to this organization in the NPPES registry on October 20, 2006.

Where is Jackson VA Medical Center located?

Jackson VA Medical Center is located at 1500 E Woodrow Wilson Ave, Jackson, MS 39216. The listed phone number is (601) 362-4471.

What is Jackson VA Medical Center's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Jackson VA Medical Center was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.