Individual provider Active NPI

Charles Henry Brewerton, M.D.

  • Obstetrics & Gynecology Physician
  • Jackson, MS
National Provider Identifier
1376003483
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
31373 Issued in MS
Practice address
2500 North State Street
Department of Obstetrics & Gynecology/MFM Division
Jackson, MS 39216
Phone
(601) 815-9278
Fax
(601) 984-6773
NPI assigned
Mar 24, 2019
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 31373 MS Primary
Maternal & Fetal Medicine Physician 207VM0101X 31373 MS

Addresses

Primary practice location

2500 North State Street
Department of Obstetrics & Gynecology/MFM Division
Jackson, MS 39216

Mailing address

2500 North State Street
Department of Obstetrics & Gynecology/MFM Division
Jackson, MS 39216
Phone (601) 815-9278

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
I20230821003818 MS Practitioner - Obstetrics/Gynecology 9739541863 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31373MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Mississippi, P.C. Obstetrics & Gynecology CurrentSince Nov 19, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 6, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 6, 2023 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Past Accepting new patients

Locations

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

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

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Interoperability endpoints

  • Direct secure messaging: cbrewerton190544@ummc.direct-ci.com
  • Direct secure messaging: cbrewerton5340260@direct.casso.us.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1376003483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "DEPARTMENT OF OBSTETRICS & GYNECOLOGY/MFM DIVISION",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-815-9278",
            "fax_number": "601-984-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "DEPARTMENT OF OBSTETRICS & GYNECOLOGY/MFM DIVISION",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-815-9278",
            "fax_number": "601-984-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWERTON",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "31373",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MS",
            "license": "31373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.