Jackson State University
NPI 1366991523 · General Practice Physician · Jackson, MS
Jackson State University is a General Practice Physician organization in Jackson, MS (NPI 1366991523).
Provider details
- NPI number
- 1366991523
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mouzon Bass, Agent(972) 367-4845
- License
- 09707 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Jackson State University Sports Medicine
Registry dates
- Enumerated
- 2016-09-29
- Last updated
- 2016-09-29
Frequently asked questions
- What is Jackson State University's NPI number?
- Jackson State University's National Provider Identifier (NPI) is 1366991523, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackson State University?
- Jackson State University is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Jackson State University located?
- Jackson State University's practice location on file with NPPES is 1400 Jr Lynch St, Jackson, MS 39217-0002.
- What is Jackson State University's phone number?
- The practice phone number listed in the NPPES registry for Jackson State University is (601) 979-2291.
- Who is the authorized official for Jackson State University?
- The authorized official listed on Jackson State University's NPPES record is Mouzon Bass, Agent. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackson State University's NPI active?
- Yes — Jackson State University's NPI (1366991523) is active in the NPPES registry as of the last update on 2016-09-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.