Jennifer Gholson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17561 Issued in MS

Practice address

804 Robb St
Summit, MS 39666-8291

Phone

(601) 276-7665

NPI assigned

Apr 18, 2006

Last updated

Jun 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBBBDA

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.

• Keystone Medical Services of Ms, Inc

  • Emergency Medicine Physician
  • Hazlehurst, MS
  • NPI 1174691059
  Medicare reassignment NPD
• Mississippi State University

  dba John C Longest Student Health Center

  • Student Health Clinic/Center
  • Mississippi State, MS
  • NPI 1225012255
  Medicare reassignment NPD
• Jennifer D Gholson MD, LLC

  • Family Medicine Physician
  • Summit, MS
  • NPI 1487967410
  Authorized official Same address or phone
• Field Memorial Community Hospital

  dba Field Health System

  • Medicare Defined Swing Bed Hospital Unit
  • Centreville, MS
  • NPI 1447217526
  NPD (past)
• Magnolia Family Medicine, PLLC

  • Family Medicine Physician
  • McComb, MS
  • NPI 1699787515
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1174588834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396661268",
            "telephone_number": "601-276-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ROBB ST",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396668291",
            "telephone_number": "601-276-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOLSON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnathan G Freeman, DPT
• Frontline Recovery, LLC (Jolimar Recovery Center)
• Elizabeth Fuller
• Julia Garner
• Lasha Gavin
• Angela Beene Gill
• Leah Grafton-Staples
• Jessica M Green
• Janice Gunn, NP
• Kelly Hall

• Family Medicine Physician in Summit, MS
• Providers in Summit, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.