Individual provider Active NPI

Dorothey Erin Jacobs Stagner, D. C.

  • Chiropractor
  • Greenwood, MS
National Provider Identifier
1245369917
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1103 Issued in MS
Practice address
805 W Park Ave Ste 5a
Greenwood, MS 38930-2832
Phone
(662) 374-5252
NPI assigned
Mar 5, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1103 MS Primary

Addresses

Primary practice location

805 W Park Ave Ste 5a
Greenwood, MS 38930-2832

Mailing address

PO Box 10405
Greenwood, MS 38930-0405
Phone (662) 374-5252

Other identifiers 1

IdentifierTypeStateIssuer
07922069MedicaidMS

Other names 1

  • Dr. Dorothey E Jacobs Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000394 MS Practitioner - Chiropractic 3870671407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

805 W Park Ave
Suite 5a
Greenwood, MS 38930-2832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1103MSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr D Erin Jacobs DC PA Chiropractor CurrentSince Aug 9, 2010 Accepting new patients
Marvel Laboratories, LLC PastSince Aug 9, 2010 Accepting new patients
Dr. Dorothey a. Pernell, D. C., P. a. Chiropractor Past Accepting new patients

Locations

1600 Highway 82 W
Ste 200
Greenwood, MS 38930
Phone (662) 453-2949

805 W Park Ave
Ste 5A
Greenwood, MS 38930
Phone (337) 842-2257

101 S Natchez St
Kosciusko, MS 39090
Phone (662) 374-5252

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1245369917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10405",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389300405",
            "telephone_number": "662-374-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W PARK AVE STE 5A",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302832",
            "telephone_number": "662-374-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS STAGNER",
        "first_name": "DOROTHEY",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2026-09-29",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07922069",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHEY",
            "last_name": "JACOBS",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.