NPIMap

Individual provider Active NPI

Jared Lee Vinson, DO

  • Internal Medicine Physician
  • Keesler Afb, MS
National Provider Identifier
1164087631
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0068113 Issued in CO
Practice address
81 MDSS/Gme
301 Fisher St, Rm1G123
Keesler Afb, MS 39534
Phone
(228) 376-3728
NPI assigned
May 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DR.0068113 CO Primary

Addresses

Primary practice location

81 MDSS/Gme
301 Fisher St, Rm1G123
Keesler Afb, MS 39534

Mailing address

81 MDSS/Gme
301 Fisher St, RM 1G123
Keesler Afb, MS 39534
Phone (228) 376-3728

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
I20241209002541 MS Practitioner - HospitalistPractitioner - Internal Medicine 7214347244 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River GulfportGroup PAC ID 5294154829, 75 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7112

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

  • Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
  • Saads Home Nursing of Ms Home health agency, Diberville, MS, CCN 257128
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068113COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Sep 23, 2024 Accepting new patients
Singing River Health System CurrentSince Jan 22, 2026 Accepting new patients
Singing River Health System Internal Medicine CurrentSince Jan 22, 2026 Accepting new patients
Singing River Gulfport CurrentSince Jan 22, 2026 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Sep 23, 2024 Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Organizations & group practices 7

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 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1164087631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MDSS/GME",
            "address_2": "301 FISHER ST, RM 1G123",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "39534",
            "telephone_number": "228-376-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MDSS/GME",
            "address_2": "301 FISHER ST, RM1G123",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "39534",
            "telephone_number": "228-376-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "JARED",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0068113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keesler Afb, MS

Sources for this page

Verify at the official NPI Registry.