Active NPI
James L. Jelks Jr., R. PH.
- Durable Medical Equipment & Medical Supplies
- Centreville, MS
National Provider Identifier
1710016233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 149 Main St.
Centreville, MS 39631-0159 - Phone
- (601) 645-5411
- Fax
- (601) 645-6454
- NPI assigned
- Mar 2, 2007
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-06942 | MS | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X | 01649 | MS |
Addresses
Primary practice location
149 Main St.
Centreville, MS 39631-0159
Mailing address
PO Box 159
Centreville, MS 39631-0159
Phone (601) 645-5411
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00440293 | Medicaid | MS | |
| 00030372 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-06942 | MS | MD | Pharmacist |
| 01649 | MS | MD | Community/Retail Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1710016233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 159",
"city": "CENTREVILLE",
"state": "MS",
"postal_code": "396310159",
"telephone_number": "601-645-5411",
"fax_number": "601-645-6454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 MAIN ST.",
"city": "CENTREVILLE",
"state": "MS",
"postal_code": "396310159",
"telephone_number": "601-645-5411",
"fax_number": "601-645-6454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELKS",
"first_name": "JAMES",
"middle_name": "L.",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "R. PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-06942",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MS",
"license": "01649",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00440293",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00030372",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centreville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.