Individual provider Active NPI

Cheryl Lynn Gladney, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1366401465
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15993 Issued in MS
Practice address
1225 N State St
Jackson, MS 39202-2064
Phone
(601) 664-1300
Fax
(601) 292-4262
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Mississippi School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Daughters Medical Center 75 clinicians

Practice addresses (Care Compare)

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

Hospital & facility affiliations

  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

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
I20110113000747 MS Practitioner - HospitalistPractitioner - Internal Medicine 8729277249 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medcial Center, Inc. CurrentSince Apr 4, 2019 Accepting new patients
King'S Daughters Medical Center CurrentSince Feb 22, 2011 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Kings Daughters Medical Center Current Accepting new patients
King'S Daughters Medical Center CurrentSince Feb 22, 2011 Accepting new patients
North Mississippi Medical Center Inc. Internal Medicine CurrentSince Apr 4, 2019 Accepting new patients
Premier Medical Group of Mississippi LLC Past Accepting new patients
Premier Medical Group of Mississippi LLC Past Accepting new patients

Locations

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 15993 MS
Internal Medicine Physician 207R00000X 15993 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

1225 N State St
Jackson, MS 39202-2064

Mailing address

1151 N State St
Suite 504
Jackson, MS 39202-2407
Phone (601) 292-4261

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00123468MedicaidMS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 21, 2023.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1366401465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 504",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-292-4261",
            "fax_number": "601-292-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "601-664-1300",
            "fax_number": "601-292-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADNEY",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "15993",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123468",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.