NPIMap

Individual provider Active NPI

Jessica Lynn Douglas, MD

  • Family Medicine Physician
  • Bay St Louis, MS
National Provider Identifier
1194188722
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26862 Issued in MS
Practice address
149 Drinkwater Rd
Bay St Louis, MS 39520-1658
Phone
(228) 467-8600
Fax
(228) 395-1225
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 27

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.

View all 27

Hospital & facility affiliations 5

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Mississippi - University of Mississippi Medical Center 956 clinicians

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

Hospital & facility affiliations

  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • Compassus-Jackson Hospice, Flowood, MS, CCN 251586
  • Merit Health Madison Hospital, Canton, MS, CCN 250038
  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20190906002922 MS Practitioner - Family Practice 0345538971 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26862MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Jul 29, 2019 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 28, 2024 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Jul 29, 2019 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 28, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
St Dominic-Jackson Memorial Hospital Past Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

4540 Shepherd Sq
Diamondhead, MS 39525
Phone (228) 255-8216

764 Lakeland Dr
Jackson, MS 39216
Phone (601) 982-0611

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2466 Flowood Dr
Jackson, MS 39232
Phone (601) 414-6520

764 Lakeland Dr
Fl 2
Jackson, MS 39216
Phone (601) 984-6800

Interoperability endpoints

  • Direct secure messaging: jdouglas34295@ummc.direct-ci.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26862 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

149 Drinkwater Rd
Bay St Louis, MS 39520-1658

Mailing address

149 Drinkwater Rd
Bay St Louis, MS 39520-1658
Phone (228) 467-8600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 19, 2019.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1194188722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8600",
            "fax_number": "228-395-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8600",
            "fax_number": "228-395-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "26862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay St Louis, MS

Sources for this page

Verify at the official NPI Registry.