John Abernathy
Individual provider Active NPI Internal Medicine Physician · Jackson, MS
NPI 1700670650 · NPPES record last updated Jul 4, 2025
Key facts
- NPI
- 1700670650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- T-5881 (MS)
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 984-1000
- NPI assigned
- Apr 7, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250904002697 | MS | Order and Referring Only - Internal Medicine |
4385146885 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | T-5881 | MS | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-1000
Other providers in Jackson, MS
- Abdu Mohamed Abdallah Ahmed
- Sarah Lindsey Abdeen
- Ashraf Sami Abdo
- Rania Abdo
- Alex Stephens Abernathy
- Sarah L Abernathy
- Albert Kalil Abide III
- Charlene Similoluwa Abidun
- Ability Home Care, LLC
- Jordan Thomas Abney
All providers in Jackson, MS · Internal Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.