Active NPI
Mary Gunn Prewitt, AU.D., CCC-A
- Audiologist
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A3929
- Practice address
- 2500 North State Street
Jackson, MS 39216-4500 - Phone
- (601) 815-3781
- Fax
- (601) 984-5085
- NPI assigned
- May 22, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A3929 | MS | Primary |
Addresses
Primary practice location
2500 North State Street
Jackson, MS 39216-4500
Mailing address
2500 North State Street
JMM Room 2525
Jackson, MS 39216-4500
Phone (601) 984-6426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02287740 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.94 of 100
- Quality
- 67.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.17
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A3929 | MS | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| University Physicians, PLLC | Past | Accepting new patients | |
| Desoto Thyroid and Endocrinology | Past | Accepting new patients |
Locations
764 Lakeland Dr
Jackson, MS 39216
Phone (601) 982-0611
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
2500 N State St
Rm 2525
Jackson, MS 39216
Phone (601) 984-1530
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JFDIBD
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
- Jackson, MS
- NPI 1154317527
-
- Prosthetic/Orthotic Supplier
- Jackson, MS
- NPI 1235019530
-
- Specialist
- Southaven, MS
- NPI 1710134945
-
- Internal Medicine Physician
- Jackson, MS
- NPI 1609984574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522368000000",
"number": "1306258553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 NORTH STATE STREET",
"address_2": "JMM ROOM 2525",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-6426",
"fax_number": "601-984-6439"
},
{
"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": "392164500",
"telephone_number": "601-815-3781",
"fax_number": "601-984-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREWITT",
"first_name": "MARY GUNN",
"name_prefix": "Dr.",
"credential": "AU.D., CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-22",
"last_updated": "2018-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A3929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02287740",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.