Active NPI
Jordan Michael Roussel, MD
- Gastroenterology Physician
- Biloxi, MS
National Provider Identifier
1205290350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 29976
- Practice address
- 14209 Cook Rd
Suite 200
Biloxi, MS 39532 - Phone
- (228) 867-4150
- Fax
- (228) 875-9558
- NPI assigned
- Apr 5, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 29976 | MS | Primary |
Addresses
Primary practice location
14209 Cook Rd
Suite 200
Biloxi, MS 39532
Mailing address
PO Box 1810
Gulfport, MS 39502
Phone (228) 575-1194
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14209 Cook Rd
Suite 200
Biloxi, MS 39532-9719
Phone (228) 575-2536
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 190 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 242 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Gastroenterology | Current | Accepting new patients |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Locations
14209 Cook Rd
#200
Biloxi, MS 39532
Phone (228) 575-2536
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
4500 W Railroad St
Gulfport, MS 39501
Phone (228) 863-8836
1501 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 822-6110
Interoperability endpoints
- jroussel@direct.mhg.com
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
Hospital & facility affiliations 60
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1205290350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1810",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39502",
"telephone_number": "228-575-1194",
"fax_number": "228-575-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14209 COOK RD",
"address_2": "SUITE 200",
"city": "BILOXI",
"state": "MS",
"postal_code": "39532",
"telephone_number": "228-867-4150",
"fax_number": "228-875-9558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSSEL",
"first_name": "JORDAN",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-05",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MS",
"license": "29976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.