NPIMap

Individual provider Active NPI

Canon Jade Beissel, MD

  • Nephrology Physician
  • Grenada, MS
National Provider Identifier
1154483394
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
16518 Issued in MS
Practice address
35 W Monroe St
Grenada, MS 38901-5222
Phone
(662) 226-8229
Fax
(662) 226-3300
NPI assigned
Dec 14, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 16518 MS Primary

Addresses

Primary practice location

35 W Monroe St
Grenada, MS 38901-5222

Mailing address

PO Box 1041
Grenada, MS 38902-1041
Phone (662) 226-9866

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
I20080617000689 MS Practitioner - NephrologyPractitioner - Internal Medicine 3274604376 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Mississippi School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahatchie General HospitalGroup PAC ID 1052208097, 20 clinicians
Delta Hills Nephrology Clinics PLLCGroup PAC ID 4486098555, 4 clinicians
Delta Hills Nephrology AssociatesGroup PAC ID 0941248579, 3 clinicians
Grenada Physician Services, LLCGroup PAC ID 4284965773, 15 clinicians

Practice addresses (Care Compare)

1301 Sunset Dr
Suite E
Grenada, MS 38901-4103
Phone (662) 625-7191

141 Dr T T Lewis Circle
Charleston, MS 38921-2236
Phone (662) 647-5392

35 W Monroe St
Grenada, MS 38901-5222
Phone (662) 226-5112

609 Tallahatchie St
Greenwood, MS 38930-2005
Phone (601) 453-5208

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

965 Avent Dr
Grenada, MS 38901-5045
Phone (662) 227-7444

Hospital & facility affiliations

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 Current Accepting new patients
Tallahatchie General Hospital CurrentSince Aug 5, 2013 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 17, 2016 Accepting new patients
Tallahatchie General Hospital CurrentSince Sep 1, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
Delta Hills Nephrology Clinics PLLC Nephrology CurrentSince Jan 14, 2024 Accepting new patients
Delta Hills Nephrology Associates Nephrology CurrentSince Jul 1, 2003 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Sep 17, 2016 Accepting new patients
Grenada Physician Services, LLC CurrentSince May 22, 2020 Accepting new patients
Tallahatchie General Hospital CurrentSince Aug 5, 2013 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Past Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

609 Tallahatchie St
Greenwood, MS 38930
Phone (601) 453-5208

1301 Sunset Dr
Ste E
Grenada, MS 38901
Phone (662) 229-0069

33 W Monroe St
Grenada, MS 38901

35 W Monroe St
Grenada, MS 38901
Phone (662) 226-5112

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

960 Avent Dr
Ste 102
Grenada, MS 38901
Phone (662) 227-7492

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

Interoperability endpoints

  • Direct secure messaging: bolv_-_dr._canon_beissel_physician@yourcarecommunity.org
  • Direct secure messaging: canon.beissel.1@29589.direct.athenahealth.com
  • Direct secure messaging: canon.beissel@scs-direct.glh.org
  • Direct secure messaging: cbeissel22261@ummc.direct-ci.com

Organizations & group practices 12

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 10

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": "1183939200000",
    "number": "1154483394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1041",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389021041",
            "telephone_number": "662-226-9866",
            "fax_number": "662-453-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W MONROE ST",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015222",
            "telephone_number": "662-226-8229",
            "fax_number": "662-226-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEISSEL",
        "first_name": "CANON",
        "middle_name": "JADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "16518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

Verify at the official NPI Registry.