Individual provider Active NPI

Myrna Alexander, M.D.

  • Cardiovascular Disease Physician
  • Jackson, MS
National Provider Identifier
1285648063
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
14525 Issued in MS
Practice address
2500 North State Street
Jackson, MS 39216-4608
Phone
(601) 984-5678
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 14525 MS Primary

Addresses

Primary practice location

2500 North State Street
Jackson, MS 39216-4608

Mailing address

2500 North State Street
Jackson, MS 39216-4500
Phone (601) 984-5678

Other identifiers 2

IdentifierTypeStateIssuer
0115251MedicaidMS
138225MedicaidAL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000180 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7012015183 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne General Hospital Current Accepting new patients
Wayne General Hospital CurrentSince Jul 1, 2020 Accepting new patients
Yalobusha General Hospital CurrentSince Aug 28, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Yalobusha General Hospital CurrentSince Aug 28, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Yalobusha General Hospital Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
Wayne General Hospsital CurrentSince Jul 1, 2020 Accepting new patients
Jackson Cardiology Associates, P.a. Cardiovascular Disease Past Accepting new patients
St. Dominic Jackson Memorial Past Accepting new patients

Locations

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

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

604 S Main St
Water Valley, MS 38965
Phone (662) 473-1311

940 Matthew Dr
Ste 5
Waynesboro, MS 39367
Phone (601) 735-7102

950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1285648063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5678",
            "fax_number": "601-984-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164608",
            "telephone_number": "601-984-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "MYRNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "14525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115251",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138225",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.