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NORTH JACKSON MEDICAL CLINIC PLLC
NPI 1659471407
Internal Medicine in Jackson, MS

Active since September 22, 2006CLIA 25D0964920 · Waiver
5160 GALAXIE DR, JACKSON, MS 39206(601) 713-0890(601) 366-3415 Get Directions Write a Review

NPPES record last updated: April 8, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Jackson Medical Clinic Pllc NPPES

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

NORTH JACKSON MEDICAL CLINIC PLLC (NPI 1659471407) is a healthcare organization registered as an internal medicine in Jackson, Mississippi and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through September 6, 2027 and lists Adesola F Shekoni, Physician, as its authorized official.

NPPES Registry Identity

NPI1659471407
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNORTH JACKSON MEDICAL CLINIC PLLC
Location Address5160 GALAXIE DRJackson, MS 39206-4308
Mailing AddressPo Box 4522Jackson, MS 39296-4522 · (601) 713-0890 · Fax (601) 366-3415
Phone(601) 713-0890
Fax(601) 366-3415
Organization SubpartNo
Authorized OfficialAdesola F ShekoniPhysician · (601) 713-0890
Enumeration DateSeptember 22, 2006
Last NPPES UpdateApril 8, 2008
✔ NPI 1659471407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MS · 15143
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5160 GALAXIE DR, Jackson, MS 39206
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Other Identifiers 10

Medicare UPING39596MS
Other220338401BMS · Bluecross Of Mississippi
Medicare PIN110001218MS
Medicare PIN110001219MS
Medicaid00117502MS
Medicaid9015073MS
Other109808399BMS · Bluecross Of Mississippi
Medicare UPING17176MS
Medicare PINC02475MS
Medicaid00115572MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D0964920

North Jackson Medical Clinic PLLC · Jackson, MS
Active · expires Sep 6, 2027
CLIA Number25D0964920
Laboratory TypePhysician Office
Certificate Effective DateSeptember 7, 2025
Certificate Expiration DateSeptember 6, 2027
Laboratory DirectorNurudeen F. Shekoni
Laboratory Phone(601) 713-0890
Laboratory LocationNorth Jackson Medical Clinic PLLC5160 Galaxie Drive, Jackson, MS 39206
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

VANESSA LOUISE MCBRIDE NP-C
Nurse Practitioner (Family)
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (601) 713-0890
LEAP ONE ENTERPRISE PLLC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (615) 525-1019
LAGINA FOSTER M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (601) 713-0890
DR. NURUDEEN SHEKONI MD
Internal Medicine
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (601) 713-0890
KAYE KILLINGS CFNP
Nurse Practitioner (Adult Health)
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (601) 713-0890
DR. ADESOLA F SHEKONI MD
Internal Medicine
5160 GALAXIE DR
JACKSON, MS 39206
Hinds County (601) 713-0890

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 North Jackson Medical Clinic PLLC's NPI number?

The NPI number for North Jackson Medical Clinic PLLC is 1659471407. It was assigned to this organization in the NPPES registry on September 22, 2006.

Where is North Jackson Medical Clinic PLLC located?

North Jackson Medical Clinic PLLC is located at 5160 Galaxie Dr, Jackson, MS 39206. The listed phone number is (601) 713-0890.

What is North Jackson Medical Clinic PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does North Jackson Medical Clinic PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0964920) is associated with this NPI, valid through September 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for North Jackson Medical Clinic PLLC was last updated on April 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.