NPIMap

Individual provider Active NPI

John Stephen Lutz Jr., M.D.

  • Interventional Pain Medicine Physician
  • Jackson, MS
National Provider Identifier
1255628020
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
23833 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
NPI assigned
Jun 30, 2011
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 23833 MS
Interventional Pain Medicine Physician 208VP0014X 23833 MS Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1026 N Flowood Dr
Jackson, MS 39232-9532
Phone (844) 824-6605

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-1000

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623002103 MS Practitioner - Pain ManagementPractitioner - Anesthesiology 0042536997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of Mississippi School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians

Practice addresses (Care Compare)

1211 S Gloster St
Suite a
Tupelo, MS 38801-6548
Phone (662) 767-4200

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

4506 Lakeland Dr
Flowood, MS 39232-9583
Phone (601) 354-4488

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Orthopedic Group of Ms, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center CurrentSince Jan 1, 2023 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Jan 1, 2026 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC Past Accepting new patients

Locations

1325 E Fortification St
Jackson, MS 39202
Phone (601) 354-4488

100 Baptist Memorial Cir
Ste 330
Oxford, MS 38655
Phone 6627674200 ext. 1057

723 Concordia Ave
Oxford, MS 38655

723 Concordia Ave
Ste 102
Oxford, MS 38655
Phone 66276742001057

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1255628020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 N FLOWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329532",
            "telephone_number": "844-824-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "23833",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MS",
            "license": "23833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.