Emmanuel Delase Agbeti · Family Medicine Physician

2500 North State Street, Jackson, MS 39216

Overview

Emmanuel Delase Agbeti is a Family Medicine Physician practicing in Jackson, Mississippi. The National Provider Identifier (NPI) is #1124815352, which was assigned on April 22, 2025, and the registration record was last updated on August 14, 2025. The practitioner's main practice location is at 2500 North State Street, Jackson, MS 39216; the contact telephone number is 6019845426. The primary taxonomy of Emmanuel Delase Agbeti is Family Medicine Physician (207Q00000X). Emmanuel Delase Agbeti is licensed to practice in the state of Mississippi (#T-5939).

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Provider Information

NPI 1124815352
Entity Type Individual
Provider Name MR. EMMANUEL DELASE AGBETI
Gender Male
Credential M.D
Practice Address 2500 North State Street
Jackson
MS 39216
Practice Telephone 6019845426
Mailing Address 2500 North State Street
Jackson
MS 39216
Enumeration Date 2025-04-22
Last Update Date 2025-08-14
Is Sole Proprietor N

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N390200000XStudent in an Organized Health Care Education/Training Program
Y207Q00000XFamily MedicineT-5939MS

Taxonomy Information

Primary Taxonomy

Code 207Q00000X
Taxonomy Family Medicine Physician
Classification Family Medicine
Grouping Allopathic & Osteopathic Physicians
Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Other Taxonomy

Code 390200000X
Taxonomy Student in an Organized Health Care Education/Training Program
Classification Student in an Organized Health Care Education/Training Program
Grouping Student, Health Care
Definition: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

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Location Information

Street Address 2500 NORTH STATE STREET
City JACKSON
State MS
Zip Code 39216
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Swathi Yarlagadda 2500 North State Street, Jackson, MS 39216Anatomic Pathology & Clinical Pathology Physician2025-04-22
Daniel Valente 2500 North State Street, Jackson, MS 39216Pediatric Anesthesiology Physician2025-05-21
Precious Chikezie Ozuomba 2500 North State Street, Jackson, Ms, Jackson, MS 39216Family Medicine Physician2025-04-11
Shankar Praharaju Girija Giri · G. Shankar Giri 2500 North State Street, University of Ms Medical Center-Radiation Oncology, Jackson, MS 39216-4505Radiation Oncology Physician2006-08-19
Nivedha Kosalram 2500 North State Street, Jackson, MS 39216Student in an Organized Health Care Education/Training Program2025-06-10
Fnu Samra Mariyam 2500 North State Street, Department of Pathology, Jackson, MS 39216Anatomic Pathology & Clinical Pathology Physician2025-05-20
Basim Ahmed Khan 2500 North State Street, University of Mississippi Medical Center, Jackson, MS 39216Psychiatry Physician2021-05-18
Jacob Moremen 2500 North State Street, Jackson, MS 39216-4500Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician2009-03-06
Alexis Jalea Saynes Tiu 2500 North State Street, Jackson, MS 39216Family Medicine Physician2025-04-18
Ishaa Saleem Siddiqui 2500 North State Street, Department of Pathology, Unive, Jackson, MS 39216Anatomic Pathology & Clinical Pathology Physician2025-04-11
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Mohamed Ghonim 2500 N. State Street, Jackson, MS 39216Internal Medicine Physician2025-04-08
Suneel Arwani 2500 N. State St., Jackson, MS 39216Student in an Organized Health Care Education/Training Program2025-06-05
Martha T. Rosen · Tillie Or Tilghman P. Rosen 1855 Crane Ridge Drive, Jackson, MS 39216Clinical Social Worker2025-07-22
Fatima Bhojani 2500 N State St, Jackson, Ms 39216, Jackson, MS 39216Pediatric Radiology Physician2025-10-22
Xin Qi 971 Lakeland Dr Ste 557, Jackson, MS 39216Neurology Physician2015-03-27
Modupe Harriet Ajisafe Department of Family Medicine, 2500 N State St, Jackson, MS 39216Family Medicine Physician2025-04-16
Marcus Berry 3304 N State St Ste 201a, Jackson, MS 39216-3129Family Nurse Practitioner2019-03-20
Kever Anthony Lewis 2500 N State St, Department of Surgery, Jackson, MS 39216Surgery Physician2022-03-25
Premier Behavioral Health of Jxn, PLLC 3304 N State St Ste 201a, Jackson, MS 39216-3129Mental Health Clinic/Center (Including Community Mental Health Center)2025-06-12
Nayan Agarwal 2500 N State Street, Jackson, MS 39216Student in an Organized Health Care Education/Training Program2025-04-15
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.