Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Ellisville State School

Health Maintenance Organization in Ellisville, MS · enumerated 2006 · authorized official Pam Young, Accounting Auditor 1.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1720181191

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Registry record

Entity type Organization (Type 2)

Legal business name Ellisville State School

Other name <Unavail>

Practice address 1101 Highway 11 S, Ellisville, MS, 39437

Phone (601) 477-9384

Fax (601) 477-5700

Enumeration date Sep 7, 2006

Last updated in NPPES Jun 12, 2008

Taxonomy & classification

302R00000X Health Maintenance Organization Managed Care Organizations · License 233 (MS) Primary

Authorized official

Name Pam Young

Title Accounting Auditor 1

Phone (601) 477-5606

Other identifiers

Identifier	Type	State	Issuer
00021831	Medicaid	MS	-

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.

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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 2008-06-12. Verify at npiregistry.cms.hhs.gov.

Where is Ellisville State School located?

The practice location on file with NPPES is in Ellisville, MS.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-06-12.