Individual provider Active NPI

Marylin Janet Fouche, M.D.

  • Anesthesiology Physician
  • Jackson, MS
National Provider Identifier
1356653877
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
23227 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5900
NPI assigned
Jul 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 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 T-2313 MS
Anesthesiology Physician 207L00000X 23227 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500

Other practice location 1

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

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
I20140908001926 MS Practitioner - Anesthesiology 8022237932 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians

Practice addresses (Care Compare)

1030 River Oaks Dr
Flowood, MS 39232-9553
Phone (601) 932-1030

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

  • University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
  • Merit Health River Region Hospital, Vicksburg, MS, CCN 250031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23227MSMDAnesthesiology Physician
T-2313MSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jul 31, 2023 Accepting new patients
Jackson Anesthesia Associates PA Anesthesiology CurrentSince Aug 1, 2014 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 20, 2023 Accepting new patients
Anesthesia Consultants PA Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 20, 2023 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 31, 2023 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1053 River Oaks Dr
#C
Flowood, MS 39232
Phone (601) 969-1430

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

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

Interoperability endpoints

  • Direct secure messaging: mfouche9613@ummc.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1356653877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-264-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUCHE",
        "first_name": "MARYLIN",
        "middle_name": "JANET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "T-2313",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "23227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.