Individual provider Active NPI

Sally Joyce White McClung, MD

  • Dermatology Physician
  • Jackson, MS
National Provider Identifier
1083364533
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
37017 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-1000
NPI assigned
Mar 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 37017 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

5334 Carolwood Dr
Jackson, MS 39211-4267

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
I20250214001801 MS Order and Referring Only - DermatologyPractitioner - Dermatology 8921538323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: sally.mcclung.1@20428.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1083364533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 CAROLWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114267"
        },
        {
            "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": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUNG",
        "first_name": "SALLY",
        "middle_name": "JOYCE WHITE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-27",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "37017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.