John Woody Sistrunk, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

15819 Issued in MS

Practice address

971 Lakeland Dr
Suite 353
Jackson, MS 39216-4643

Phone

(601) 949-6990

Fax

(601) 949-6105

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

EndocrinologyAlso: Nuclear Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jackson Thyroid and Endocrine Clinic PLLCGroup PAC ID 4284902289, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jackson Thyroid & Endocrine Clinic PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MS
  • NPI 1134671787
  Medicare reassignment Care Compare group Authorized official

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1164430419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 353",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-949-6990",
            "fax_number": "601-949-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 353",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-949-6990",
            "fax_number": "601-949-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTRUNK",
        "first_name": "JOHN",
        "middle_name": "WOODY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "15819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124713",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Sink
• Henry Justin Sioufi, MD
• Jeska H Sisk, OTR/L
• Lillian Caroline Sisson
• Sisters in Birth, Inc.
• Madison N Sistrunk
• Mark J Sistrunk, CRNA
• Tony Lee Sistrunk, CRNA
• William E Sistrunk, MD
• Caroline Sit

• Endocrinology, Diabetes & Metabolism Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Endocrinology, Diabetes & Metabolism Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.