Individual provider Active NPI

Joanna Diane Bayles, D,I,

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1629365358
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T-2402 Issued in MS
Practice address
878 Lakeland Dr
Jackson, MS 39216-4644
Phone
(601) 984-6800
Fax
(601) 984-6811
NPI assigned
Jul 1, 2011
Last updated
Jul 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T-2402 MS Primary

Addresses

Primary practice location

878 Lakeland Dr
Jackson, MS 39216-4644

Mailing address

PO Box 4999
Jackson, MS 39296-4999
Phone (601) 984-5426

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160229000059 MS Practitioner - Family Practice 9638390529 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2402MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Apr 1, 2018 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

149 Drinkwater Rd
Fl 2
Bay St Louis, MS 39520
Phone (228) 395-1255

202B Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 463-9457

4540 Shepherd Sq
Diamondhead, MS 39525
Phone (228) 255-8216

5435 Gex Rd
Diamondhead, MS 39525
Phone (228) 255-8216

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1629365358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4999",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964999",
            "telephone_number": "601-984-5426",
            "fax_number": "601-984-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164644",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLES",
        "first_name": "JOANNA",
        "middle_name": "DIANE",
        "credential": "D,I,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.