Active NPI
John Demetro Zelem, M.D.
- Surgery Physician
- Booneville, MS
National Provider Identifier
1467400358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 18717
- Practice address
- 100 Hospital St
Suite 100a
Booneville, MS 38829-3354 - Phone
- (662) 720-5131
- Fax
- (662) 720-5135
- NPI assigned
- May 4, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 18717 | MS | Primary |
| Surgery Physician | 208600000X | 019923 | CT |
Addresses
Primary practice location
100 Hospital St
Suite 100a
Booneville, MS 38829-3354
Mailing address
100 Hospital St
Suite 100a
Booneville, MS 38829-3354
Phone (662) 720-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03331273 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019923 | CT | MD | Surgery Physician |
| 18717 | MS | MD | Surgery Physician |
| 011923 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467400358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL ST",
"address_2": "SUITE 100A",
"city": "BOONEVILLE",
"state": "MS",
"postal_code": "388293354",
"telephone_number": "662-720-5131",
"fax_number": "662-720-5135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL ST",
"address_2": "SUITE 100A",
"city": "BOONEVILLE",
"state": "MS",
"postal_code": "388293354",
"telephone_number": "662-720-5131",
"fax_number": "662-720-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELEM",
"first_name": "JOHN",
"middle_name": "DEMETRO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MS",
"license": "18717",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "019923",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03331273",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Booneville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.