Jennifer Leticia Grayson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17609 Issued in MS

Practice address

147 Reynoir St Ste 202
Biloxi, MS 39530-4109

Phone

(228) 594-8000

Fax

(228) 594-8002

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drgrayson@abcpeds1.opdirect.net

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.

• Gulf Coast Abc Pediatrics, Inc.

  • Pediatrics Physician
  • Biloxi, MS
  • NPI 1720302508
  NPD (past) Authorized official
• Franklin Primary Health Center, Inc

  dba Frisco City Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Frisco City, AL
  • NPI 1982024402

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1346357498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 6579",
            "city": "D'IBERVILLE",
            "state": "MS",
            "postal_code": "39540",
            "telephone_number": "228-594-8000",
            "fax_number": "228-594-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 REYNOIR ST STE 202",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304109",
            "telephone_number": "228-594-8000",
            "fax_number": "228-594-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "JENNIFER",
        "middle_name": "LETICIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "17609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "680498058",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125565",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John William Graves
• Antonette Gray, CRNA
• Rachel Gray, LCSW
• Stephanie Theresa Gray
• Cavosany Graymack
• Dennis N. Green, D.D.S.
• Jasmine Green
• Justine Alana Green
• Nancy Jean Green, PMHNP-BC
• Tina Louise Greer, SPED TEACHER

• Pediatrics Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.