NPIMap

Individual provider Active NPI

Mukesh Jain, MD

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1447282991
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14601 Issued in MS
Practice address
7615 Clarington CV
Southaven, MS 38671-5647
Phone
(662) 536-2500
Fax
(662) 536-2505
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25718 TN
Specialist 174400000X 14601 MS
Hospitalist Physician 208M00000X 14601 MS
Internal Medicine Physician 207R00000X 14601 MS Primary

Addresses

Primary practice location

7615 Clarington CV
Southaven, MS 38671-5647

Mailing address

7615 Clarington CV
Southaven, MS 38671-5647
Phone (662) 536-2500

Other practice location 1

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2980

Other identifiers 2

IdentifierTypeStateIssuer
05128319MedicaidMS
06326035MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111206000240 TN Practitioner - Internal Medicine 7214835263 Reassigns benefits to 1 organization
I20120105000325 MS Practitioner - Internal Medicine 7214835263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1785 Nonconnah Blvd
Memphis, TN 38132-2139
Phone (901) 344-0101

7615 Clarington CV
Southaven, MS 38671-5647
Phone (662) 536-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25718TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Landmark Internal Medicine Specialist CurrentSince Jul 18, 1995 Accepting new patients

Locations

7615 Clarington Cv
Southaven, MS 38671
Phone (662) 536-2500

6733 Quince Rd
Memphis, TN 38119
Phone (901) 288-7877

1264 Wesley Dr
Ste 502
Memphis, TN 38116
Phone (901) 333-2525

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIHAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIHAA/Endpoint/JJIHAA
  • Direct secure messaging: mjain4350@direct.bmhcc.org
  • Direct secure messaging: mjain30537@mlh.direct-ci.com

Organizations & group practices 1

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 9

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1447282991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715647",
            "telephone_number": "662-536-2500",
            "fax_number": "662-536-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 CLARINGTON CV",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715647",
            "telephone_number": "662-536-2500",
            "fax_number": "662-536-2505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Southcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714739",
            "country_code": "US",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "MUKESH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "25718",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "14601",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "14601",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "14601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05128319",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06326035",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.