NPIMap

Individual provider Active NPI

Menarvia Nixon Gaddis, MD

  • Neurological Surgery Physician
  • Jackson, MS
National Provider Identifier
1407173453
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25030 Issued in MS
Practice address
1200 N State St Ste 420
Jackson, MS 39202-2027
Phone
(601) 355-3353
Fax
(601) 355-3365
NPI assigned
Apr 30, 2010
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 25030 MS Primary

Addresses

Primary practice location

1200 N State St Ste 420
Jackson, MS 39202-2027

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170918000220 MS Practitioner - Neurosurgery 8729384185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Howard University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1151 N State St
Suite 404
Jackson, MS 39202-2457
Phone (601) 292-4261

1200 N State St
Jackson, MS 39202-2027

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion31
Laminectomy or laminotomy (partial removal of spine bones)19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25030MSMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Ms CurrentSince Jan 1, 2023 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Jan 1, 2023 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Neurological Surgery CurrentSince Jan 1, 2023 Accepting new patients
River Oaks Management Company LLC Past Accepting new patients

Locations

1200 N State St
Ste 420
Jackson, MS 39202
Phone (601) 355-3353

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

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Interoperability endpoints

  • Direct secure messaging: mgaddis190604@direct.bmhcc.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1407173453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 420",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-355-3353",
            "fax_number": "601-355-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "MENARVIA",
        "middle_name": "NIXON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "25030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.