Beverly Gwen Windham, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

D0056056 Issued in MD

Practice address

2500 North State Street
Department of Medicine Division of Geriatrics
Jackson, MS 39216

Phone

(601) 984-5610

Fax

(601) 984-5783

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gwen Windham Oldenquist Former name

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

Specialty

Geriatric MedicineAlso: Internal Medicine

Education

University of Mississippi School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

67.75

Promoting interoperability

100

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwindham9026@ummc.direct-ci.com

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.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1477621324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DIVISION OF GERIATRICS",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5610",
            "fax_number": "601-984-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "DEPARTMENT OF MEDICINE DIVISION OF GERIATRICS",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5610",
            "fax_number": "601-984-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDHAM",
        "first_name": "BEVERLY",
        "middle_name": "GWEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0056056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08952891",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWEN",
            "last_name": "OLDENQUIST",
            "middle_name": "WINDHAM",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Travaughn Wilson
• Zachary Ryan Wilson
• Sara Graycen Wiltshire
• Christopher A Wimberley, LMFT
• Lindsey Elise Winborne
• Ian M Windmill, PHD
• Sue M Windmill, AU D
• Windsor Consulting, LLC
• Robert Wade Wineman, M.D.
• Anita Winfield, LMT

• Geriatric Medicine (Internal Medicine) Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Geriatric Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.

Verify at the official NPI Registry.