Individual provider Active NPI

Jeffrey H Glover, M.D.

  • Surgery Physician
  • Jackson, MS
National Provider Identifier
1073725933
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10993 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-6060
Fax
(601) 200-6767
NPI assigned
May 4, 2007
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 10993 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (601) 200-6060

Other practice location 1

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-5500

Other identifiers 5

IdentifierTypeStateIssuer
5023171OtherMSAETNA
1730117OtherMSUNITED HEALTHCARE
770003232OtherRAILROAD MEDICARE
1387509MedicaidLA
00016354MedicaidMS

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
I20040618001053 MS Practitioner - General Surgery 1850376435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Mississippi School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians

Practice addresses (Care Compare)

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-5500

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 364-6175

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue71
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10993MSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center CurrentSince Feb 1, 2021 Accepting new patients
St. Dominic Jackson Memorial Surgery CurrentSince May 1, 2025 Accepting new patients
St Dominic Hospital Crna's CurrentSince May 1, 2025 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Feb 1, 2021 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

971 Lakeland Dr
Ste 656
Jackson, MS 39216
Phone (601) 366-6606

1311 Aston Ave
McComb, MS 39648
Phone (601) 684-2481

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

300 Rawls Dr
Ste 200
McComb, MS 39648
Phone (601) 249-1570

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jglover2548749@direct.casso.us.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1073725933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-6060",
            "fax_number": "601-200-6767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482705",
            "country_code": "US",
            "telephone_number": "601-249-5500",
            "fax_number": "601-250-4367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JEFFREY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "10993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5023171",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1730117",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "770003232",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1387509",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016354",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.