NPIMap

Individual provider Active NPI

Jessica Suzanne Jensen, MD

  • Internal Medicine Physician
  • Corinth, MS
National Provider Identifier
1013402254
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T-3585 Issued in MS
Practice address
611 Alcorn Dr
Corinth, MS 38834-9321
Phone
(662) 293-1000
NPI assigned
Jun 29, 2018
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T-3585 MS Primary

Addresses

Primary practice location

611 Alcorn Dr
Corinth, MS 38834-9321

Mailing address

217 County Road 238
Iuka, MS 38852-8246
Phone (901) 616-7433

Other names 1

  • Jessica Suzanne Nichols Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210807000197 MS Practitioner - Internal Medicine 3870997208 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1771 Curtis Dr
Iuka, MS 38852-1001
Phone (662) 423-6014

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-3585MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Internal Medicine Current Accepting new patients
Magnolia Regional Health Center Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Aug 2, 2021 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Magnolia Hospitalist Group CurrentSince Oct 1, 2021 Accepting new patients
Tishomingo Health Services, Inc. CurrentSince May 11, 2022 Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Aug 2, 2021 Accepting new patients
Tishomingo Health Services, Inc. CurrentSince May 11, 2022 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Oct 1, 2021 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Tishomingo Community Care Center LLC Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
CLC of Iuka, LLC Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

1771 Curtis Dr
Iuka, MS 38852
Phone (662) 423-6014

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

  • Direct secure messaging: jessicajensen@nmhs.medalliesdirect.net

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1013402254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 COUNTY ROAD 238",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388528246",
            "telephone_number": "901-616-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349321",
            "telephone_number": "662-293-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JESSICA",
        "middle_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-3585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "NICHOLS",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.