NPIMap

Organization Active NPI

Miss-Lou Gi PLLC

  • Gastroenterology Physician
  • Natchez, MS
National Provider Identifier
1295492437
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MISS-LOU GI PLLC
Practice address
136 Jeff Davis Blvd
Ste B
Natchez, MS 39120
Phone
(601) 492-2224
Fax
(601) 492-2231
NPI assigned
Nov 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Dr. Kellen T Jex, MDNPI 1952698532
Title
Owner
Phone
(601) 597-4449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

136 Jeff Davis Blvd
Ste B
Natchez, MS 39120

Mailing address

136 Jeff Davis Blvd
Ste B
Natchez, MS 39120
Phone (601) 492-2224

Other identifiers 2

IdentifierTypeStateIssuer
03506041MedicaidMS
2390007MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211206001030 MS Part B Supplier - Clinic/Group Practice 3678963618 Receives reassigned benefits from 2 practitioners
Practice locations: Natchez, MS
O20220708000355 LA Part B Supplier - Clinic/Group Practice 3678963618 Receives reassigned benefits from 1 practitioner
Practice locations: Ferriday, LA; Vidalia, LA; Winnsboro, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1295492437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JEFF DAVIS BLVD",
            "address_2": "STE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-492-2224",
            "fax_number": "601-492-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JEFF DAVIS BLVD",
            "address_2": "STE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "39120",
            "telephone_number": "601-492-2224",
            "fax_number": "601-492-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS-LOU GI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "JEX",
        "authorized_official_first_name": "KELLEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-597-4449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03506041",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2390007",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.