Individual provider Active NPI

John D Belknap, MD

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1124180567
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19395 Issued in MS
Practice address
5606 Old Canton Rd
Jackson, MS 39211-4217
Phone
(601) 957-3333
Fax
(601) 957-3335
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19395 MS Primary

Addresses

Primary practice location

5606 Old Canton Rd
Jackson, MS 39211-4217

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other practice location 1

1220 E Northside Dr Ste 220
Jackson, MS 39211-5503
Phone (601) 768-8275

Other identifiers 1

IdentifierTypeStateIssuer
03179741MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.belknap.1@29601.direct.athenahealth.com

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
I20071017000043 MS Practitioner - Family Practice 5597851972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad Intermed Company LLCGroup PAC ID 6709245954, 42 clinicians

Practice addresses (Care Compare)

1220 E Northside Dr
Suite 220
Jackson, MS 39211-5503
Phone (601) 298-4173

4204 Clay St
Vicksburg, MS 39183-3438
Phone (601) 619-7717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19395MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Quad Intermed Company LLC Past Accepting new patients

Locations

342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560

4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jbelknap2546089@direct.casso.us.com
  • Direct secure messaging: john.belknap.1@29601.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1124180567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114217",
            "telephone_number": "601-957-3333",
            "fax_number": "601-957-3335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 E Northside Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392115503",
            "country_code": "US",
            "telephone_number": "601-768-8275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELKNAP",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03179741",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.belknap.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1220 E Northside Dr Ste 220",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392115503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.