Avery Villeret, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

T-4951 Issued in MS

Practice address

200 Park Creek Dr
Columbus, MS 39705-1309

Phone

(662) 327-8410

Fax

(662) 327-9749

NPI assigned

Mar 27, 2023

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• BMC - Attala, LLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1023481595
  NPD (past)
• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1699478693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281",
            "fax_number": "901-227-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK CREEK DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051309",
            "telephone_number": "662-327-8410",
            "fax_number": "662-327-9749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3748 Crane Blvd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392163605",
            "country_code": "US",
            "telephone_number": "601-622-7971",
            "fax_number": "601-622-7971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLERET",
        "first_name": "AVERY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "T-4951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Luecinda Vaughan, NP
• Mary Vaughn, DNP, FNP-C, PMHNP-C
• Vcncl, LLC
• Veal Chiropractic Center PC
• Ankita Verma, MD
• Robert D Voller, MD
• Matthew Joel Wade, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores, Inc.
• Keenyn Wald, LPC

• Pediatrics Physician in Columbus, MS
• Providers in Columbus, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.