NPIMap

Individual provider Active NPI

John Clark Henegan Jr., M.D.

  • Hematology & Oncology Physician
  • Jackson, MS
National Provider Identifier
1114188471
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
22684 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5616
Fax
(601) 984-5689
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 22684 MS Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5616

Other identifiers 1

IdentifierTypeStateIssuer
02433543MedicaidMS

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
I20160718000699 MS Practitioner - Hematology/Oncology 9830418177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Mississippi School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

Hospital & facility affiliations

  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Centerwell Home Health Home health agency, Flowood, MS, CCN 257126
  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168
  • Merit Health Madison Hospital, Canton, MS, CCN 250038
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

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 CurrentSince Jul 1, 2016 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2016 Accepting new patients

Locations

2500 N State St
Ste E
Jackson, MS 39216

5903 Ridgewood Rd
Jackson, MS 39211
Phone (601) 376-2022

2500 N State St
Rm 2525
Jackson, MS 39216
Phone (601) 984-1530

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

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jhenegan29589@ummc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1114188471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5616",
            "fax_number": "601-984-5689"
        },
        {
            "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": "601-984-5616",
            "fax_number": "601-984-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEGAN",
        "first_name": "JOHN",
        "middle_name": "CLARK",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MS",
            "license": "22684",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02433543",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.