Jeffrey S Fitzgerald, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

18973 Issued in MS

Practice address

969 Lakeland Dr
Jackson, MS 39216-4606

Phone

(601) 200-6175

Fax

(601) 200-2020

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Emergency Medicine

Education

Louisiana State University School of Medicine in New Orleans, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Relias Emergency Medicine Specialists of St Dominic LLCGroup PAC ID 2466840152, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• 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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfitzgerald2548866@direct.casso.us.com

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.

• Relias Emergency Medicine Specialists of St Dominic LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235808122
  Medicare reassignment Care Compare group NPD
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  NPD (past)
• South Mississippi Emergency Physicians PA

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1265478077
  NPD (past)
• Emergency Medicine Physicians of Davidson County, PLLC

  • Emergency Medicine Physician
  • Lexington, NC
  • NPI 1629017504
  NPD (past)

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

• 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1164449740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23457",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253457",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "18973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07753816",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Semyon Fishkin, MD
• Olivia Kate Fisscher
• James Gordon Fitchie, DMD
• Fitness Clinic
• Fitness Clinic Wellness
• Ashley Fitzhugh
• Kesha Major Flantroy, M.D.
• Zachary Taylor Flattmann
• Lasonda Flax
• Adam Brooks Fleming

• Emergency Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.