Jeremy Shane White, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

29993 Issued in MS

Practice address

501 Marshall St Ste 104
Jackson, MS 39202-1663

Phone

(601) 969-6404

Fax

(601) 973-4541

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Mississippi School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation of Central Mississippi IncGroup PAC ID 1153216411, 274 clinicians

Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Baptist Medical Center Attala Hospital, Kosciusko, MS, CCN 251336
• Baptist Medical Center-Leake Hospital, Carthage, MS, CCN 251315
• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097
• Baptist Medical Center-Yazoo Hospital, Yazoo City, MS, CCN 251313

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwhite5326706@direct.casso.us.com
• Direct secure messaging: jwhite376130@scrippshlth.medalliesdirect.net
• Direct secure messaging: jwhite521579@direct.bmhcc.org

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

• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment Care Compare group NPD
• Southwest Mississippi Regional Medical Center

  • Obstetrics & Gynecology Physician
  • McComb, MS
  • NPI 1982174488
  Medicare reassignment Care Compare group NPD
• Mississippi Baptist Medical Center, Inc.

  • Neurology Physician
  • Jackson, MS
  • NPI 1467589556
  Medicare reassignment NPD
• Medical Foundation of Central Ms

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• Mississippi Baptist Medical Center, Inc

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1962523845
  NPD
• Mississippi Baptist Medical Center, Inc.

  • Community/Retail Pharmacy
  • Jackson, MS
  • NPI 1255882890
  NPD
• Southwest Mississippi Regional Medical Center

  • Rural Health Clinic/Center
  • Summit, MS
  • NPI 1154008811
  NPD
• Southwest Ms Regional Medical Center

  • Cardiovascular Disease Physician
  • Monticello, MS
  • NPI 1255422457
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  NPD (past)
• Southwest Mississippi Regional Medical Center

  • Vascular Surgery Physician
  • McComb, MS
  • NPI 1124077581
  NPD (past)

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

• Baptist Medical Center - Yazoo, Inc

  • Critical Access Hospital
  • Yazoo City, MS
  • NPI 1619918075
  Care Compare affiliation
• Baptist Medical Center-Leake Inc

  • Critical Access Hospital
  • Carthage, MS
  • NPI 1205112539
  Care Compare affiliation
• BMC - Attala, LLC

  • Critical Access Hospital
  • Kosciusko, MS
  • NPI 1730566027
  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1104237007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST STE 104",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021663",
            "telephone_number": "601-969-6404",
            "fax_number": "601-973-4541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-9666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEREMY",
        "middle_name": "SHANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A169147",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "29993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank G White, LCMFT
• Fredniki King White, LCMHT
• Hannah Neely White
• India Marquita White, MHT
• Jamie Alexandria White, DMD
• John Henry White III, MD
• Jordan B White
• Kara Norris White, LPC
• Katrenia White, BSW
• Kelsi Ariana White

• Interventional Cardiology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Interventional Cardiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.