JEA SURGICAL, LLC
NPI 1669242822
Clinic/Center - Ambulatory Surgical in Madison, MS

Active since January 08, 2024CLIA 25D2298218 · Waiver
1026 BAPTIST CIRCLE, SUITE 101, MADISON, MS 39110(601) 353-2020 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2025, Dec 9, 2024 (2 updates tracked since 2024).

About Jea Surgical, Llc NPPES

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

JEA SURGICAL, LLC (NPI 1669242822) is a healthcare organization registered as an ambulatory surgical in Madison, Mississippi and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through January 29, 2028 and lists Shane Humphries, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1669242822
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameJEA SURGICAL, LLC
Location Address1026 BAPTIST CIRCLE, SUITE 101Madison, MS 39110
Mailing Address1026 Baptist Cir Ste 101Madison, MS 39110-2028 · (601) 353-2020 · Fax (769) 567-1069
Organization SubpartNo
Authorized OfficialShane HumphriesPractice Administrator · (601) 353-2020
Enumeration DateJanuary 8, 2024
Last NPPES UpdateJune 13, 20252 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
NPI 1669242822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
Also ListedOphthalmologyTaxonomy 207W00000X
1026 BAPTIST CIRCLE, Madison, MS 39110

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

Accepted Insurance

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 25D2298218

Jea Surgical, LLC · Madison, MS
Active · expires Jan 29, 2028
CLIA Number25D2298218
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 30, 2026
Certificate Expiration DateJanuary 29, 2028
Laboratory DirectorTaylor Smith
Laboratory Phone(601) 353-2020
Laboratory LocationJea Surgical, LLC1026 Baptist Circle Suite 101, Madison, MS 39110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Jea Surgical, LLC's NPI number?

The NPI number for Jea Surgical, LLC is 1669242822. It was assigned to this organization in the NPPES registry on January 8, 2024.

Where is Jea Surgical, LLC located?

Jea Surgical, LLC is located at 1026 Baptist Circle Suite 101, Madison, MS 39110. The listed phone number is (601) 353-2020.

What is Jea Surgical, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Jea Surgical, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2298218) is associated with this NPI, valid through January 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jea Surgical, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Jea Surgical, LLC 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 Jea Surgical, LLC was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.