Organization Active NPI

Southern Interventional Pain Specialists Jackson, PLLC

  • Interventional Pain Medicine Physician
  • Madison, MS
National Provider Identifier
1750250577
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
SOUTHERN INTERVENTIONAL PAIN SPECIALISTS JACKSON, PLLC
Practice address
401 Baptist Dr Ste 301a
Madison, MS 39110-2012
Phone
(601) 891-5524
Fax
(601) 348-8716
NPI assigned
Oct 30, 2025
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Jeremy Smitherman, MDNPI 1457507055
Title
Owner
Phone
(601) 891-5524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

401 Baptist Dr Ste 301a
Madison, MS 39110-2012

Mailing address

401 Baptist Dr Ste 301a
Madison, MS 39110-2012
Phone (601) 891-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251218001477 MS Part B Supplier - Clinic/Group Practice 1254826167 Receives reassigned benefits from 1 practitioner
Practice locations: Flowood, MS

National Provider Directory

National Provider Directory

Locations

401 Baptist Dr
Ste 301A
Madison, MS 39110
Phone (601) 891-5524

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1750250577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012",
            "telephone_number": "601-891-5524",
            "fax_number": "601-348-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012",
            "telephone_number": "601-891-5524",
            "fax_number": "601-348-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INTERVENTIONAL PAIN SPECIALISTS JACKSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-30",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "SMITHERMAN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-891-5524",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.