NPIMap

Individual provider Active NPI

Jerry M Sheppard, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1649280983
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18932 Issued in MS
Practice address
2500 N State St
Dept of Medicine Division of General Internal Medicine
Jackson, MS 39225-4146
Phone
(601) 984-2746
Fax
(601) 984-6870
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18932 MS Primary
Hospitalist Physician 208M00000X 18932 MS

Addresses

Primary practice location

2500 N State St
Dept of Medicine Division of General Internal Medicine
Jackson, MS 39225-4146

Mailing address

2500 N State St
Hospitalist
Jackson, MS 39216-4500
Phone (601) 984-6426

Other identifiers 2

IdentifierTypeStateIssuer
154127MedicaidMS
06356838MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000864 MS Practitioner - Internal Medicine 6608801048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Mississippi Baptist Medical Center, Inc Hospitalist CurrentSince Sep 1, 2016 Accepting new patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Medical Foundation of Central Mississippi, Inc CurrentSince Sep 1, 2018 Accepting new patients
Medical Foundation of Central Ms CurrentSince Sep 1, 2018 Accepting new patients
Medical Foundation of Central Mississippi, Inc. Internal Medicine Current Accepting new patients
River Oaks Management Company LLC Internal Medicine Past Accepting new patients
Mississippi Baptist Medical Center, Inc. Hospitalist Past Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients

Locations

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1225 N State St
Apt 1015
Jackson, MS 39202

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Interoperability endpoints

  • Direct secure messaging: jsheppard148252@direct.bmhcc.org

Organizations & group practices 9

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 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1649280983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "HOSPITALIST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPT OF MEDICINE DIVISION OF GENERAL INTERNAL MEDICINE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392254146",
            "telephone_number": "601-984-2746",
            "fax_number": "601-984-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JERRY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18932",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "18932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154127",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06356838",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.