Ellisville State School

Ellisville State School is a healthcare organization registered as Technician in Ellisville, MS, holding Type 2 (organization) NPI 1164582821 since 2006. The authorized official on file is Suzie Lassiter, Director of Facility.

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NPI 1164582821
Entity type Organization (Type 2)
Legal business name Ellisville State School
Other name <Unavail>
Practice address 1101 HIGHWAY 11 S, Ellisville, MS, 39437
Phone 6014779384
Fax 6014775700
Enumeration date 2006-12-11
Last updated in NPPES 2008-06-17

Authorized official

Name Suzie Lassiter
Title Director of Facility
Phone 6014779384

Taxonomy & classification

Taxonomy code Specialty Primary License State
374700000X Technician Primary ESS-BMR MS

Other identifiers

Identifier Type State Issuer
09015542 Medicaid MS
Copy-ready billing details
Provider: Ellisville State School
NPI: 1164582821
Taxonomy: 374700000X (Technician)
Address: 1101 HIGHWAY 11 S, Ellisville, MS, 39437

Providers at this address

NPI Name Type Specialty Location
1255364337 Joseph Moring Individual Emergency Medicine Physician Ellisville, MS
1225130040 Paul Hathorn Individual Dentist Ellisville, MS
1720181191 Ellisville State School Organization Health Maintenance Organization Ellisville, MS
1578668901 Ellisville State School Organization Long Term Care Pharmacy Ellisville, MS
1508962101 Lisa Blesse Individual Family Nurse Practitioner Ellisville, MS
1306914700 Hillside Organization Nursing Facility/Intermediate Care Facility Ellisville, MS
1205904604 Pecan Grove Organization Nursing Facility/Intermediate Care Facility Ellisville, MS
1598833998 Paul D. Cotten Organization Nursing Facility/Intermediate Care Facility Ellisville, MS

Verify this record

Cross-check NPI 1164582821 against the authoritative CMS record: view Ellisville State School on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-06-17. Verify at npiregistry.cms.hhs.gov.
Where is Ellisville State School located?
The practice location on file with NPPES is in Ellisville, MS.

Source: CMS NPPES (public data). Snapshot 2026-07-09. Provider record last updated 2008-06-17.