NPIMap

Organization Active NPI

Jennifer D Gholson MD, LLC

  • Family Medicine Physician
  • Summit, MS
National Provider Identifier
1487967410
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JENNIFER D GHOLSON MD, LLC
Practice address
804 Robb St
Summit, MS 39666-8291
Phone
(601) 276-7665
Fax
(601) 276-7655
NPI assigned
Jul 19, 2010
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Dr. Jennifer Gholson, MDNPI 1174588834
Title
Owner
Phone
(601) 276-7665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

804 Robb St
Summit, MS 39666-8291

Mailing address

804 Robb St
Summit, MS 39666-8291
Phone (601) 276-7665

National Provider Directory

National Provider Directory

Locations

701 Laurel St
Summit, MS 39666
Phone (601) 276-7665

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1487967410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ROBB ST",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396668291",
            "telephone_number": "601-276-7665",
            "fax_number": "601-276-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ROBB ST",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396668291",
            "telephone_number": "601-276-7665",
            "fax_number": "601-276-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER D GHOLSON MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "GHOLSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-276-7665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.