Individual provider Active NPI

Kesha Major Flantroy, M.D.

  • Obstetrics & Gynecology Physician
  • Jackson, MS
National Provider Identifier
1164630349
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME96498 Issued in FL
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 362-5321
Fax
(601) 364-5159
NPI assigned
May 19, 2007
Last updated
Jun 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME96498 FL Primary
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician 207VH0002X ME96498 FL

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

3502 W Northside Drive
Jackson, MS 39213
Phone (601) 362-5321

Other identifiers 2

IdentifierTypeStateIssuer
2001153230AMedicaidFL
01435098MedicaidMS

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
I20111108000815 MS Practitioner - Obstetrics/Gynecology 9234222076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Morehouse School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Miss Regional Medical CenterGroup PAC ID 3173969177, shared by 3 NPIs, 20 clinicians

Practice addresses (Care Compare)

129 White Oak St
Utica, MS 39175-8803
Phone (601) 885-6021

2000 N State St
Clarksdale, MS 38614-6100
Phone (662) 627-7361

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME96498FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mississippi Civic Improvement Association, Inc CurrentSince Feb 11, 2020 Accepting new patients
Central Mississippi Civic Improvement Association, Inc. CurrentSince Feb 11, 2020 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Jan 24, 2024 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Jan 24, 2024 Accepting new patients
Jackson Hma LLC Past Accepting new patients
Central Mississippi Civic Improvement Association, Inc. Past Accepting new patients
Northwest Miss Regional Medical Center Past Accepting new patients
McAlester Physician Management Services Past Accepting new patients
Samuel Floyd Brown MD Obstetrics & Gynecology Past Accepting new patients

Locations

1860 Chadwick Dr
Ste 254
Jackson, MS 39204
Phone (601) 376-2818

1860 Chadwick Dr
Ste 300
Jackson, MS 39204
Phone (601) 376-2857

3502 W Northside Dr
Jackson, MS 39213
Phone (601) 982-1625

129 White Oak St
Utica, MS 39175
Phone (601) 885-6021

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/0c0c63aa-c0e5-4256-b638-969087e4db15
  • Direct secure messaging: kesha.flantroy.1@29904.direct.athenahealth.com
  • Direct secure messaging: kesha.flantroy@jhchc.eclinicaldirectplus.com

Organizations & group practices 9

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 1

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": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1164630349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-362-5321",
            "fax_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANTROY",
        "first_name": "KESHA",
        "middle_name": "MAJOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME96498",
            "primary": true
        },
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME96498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001153230A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01435098",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.