Active NPI
John Dudley Foss, M.D.
- Internal Medicine Physician
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 17265
- Practice address
- 501 Marshall St
Suite 208
Jackson, MS 39202-1651 - Phone
- (601) 352-2273
- Fax
- (601) 206-6052
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 17265 | MS | Primary |
Addresses
Primary practice location
501 Marshall St
Suite 208
Jackson, MS 39202-1651
Mailing address
PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00012476 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Alabama School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4405 Vandever Ave
San Diego, CA 92120-3315
Phone (619) 516-6606
4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17265 | MS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Adult Care of Austin PA | Internal Medicine | Past | Accepting new patients |
| Premier Medical Group of Mississippi LLC | Past | Accepting new patients | |
| Premier Medical Group of Mississippi LLC | Past | Accepting new patients |
Locations
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
Organizations & group practices 4
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
dba Jackson Medical Clinic LLC
- Clinic/Center
- Jackson, MS
- NPI 1548219884
-
dba Kosciusko Medical Clinic
- Clinic/Center
- Kosciusko, MS
- NPI 1790827038
-
- Internal Medicine Physician
- Austin, TX
- NPI 1619982147
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kaiser Foundation Hospital San Diego
- General Acute Care Hospital
- San Diego, CA
- NPI 1013062769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1437221876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23996",
"city": "JACKSON",
"state": "MS",
"postal_code": "392253996",
"telephone_number": "601-206-6100",
"fax_number": "601-206-6052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 MARSHALL ST",
"address_2": "SUITE 208",
"city": "JACKSON",
"state": "MS",
"postal_code": "392021651",
"telephone_number": "601-352-2273",
"fax_number": "601-206-6052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSS",
"first_name": "JOHN",
"middle_name": "DUDLEY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "17265",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00012476",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.