Individual provider Active NPI

Supriya Bisht, MD

  • Neonatal-Perinatal Medicine Physician
  • Jackson, MS
National Provider Identifier
1043706518
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
33045 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(888) 815-2005
NPI assigned
Jul 7, 2018
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 33045 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

504 Clinton Center Dr Ste 4300
Clinton, MS 39056-5610
Phone (888) 815-2005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903003273 MS Practitioner - Pediatric Medicine 5597267237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

504 Clinton Ctr Dr
Suite 4300
Clinton, MS 39056

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 22, 2025 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 22, 2025 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: sbisht207457@ummc.direct-ci.com
  • Direct secure messaging: supriyabisht@nmhs.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1043706518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DR STE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "888-815-2005",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "888-815-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHT",
        "first_name": "SUPRIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MS",
            "license": "33045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.