Individual provider Active NPI

Marlaina Berch, M.D.

  • Pediatrics Physician
  • Jackson, MS
National Provider Identifier
1750743670
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26689 Issued in MS
Practice address
2500 N State St
Department of Pediatrics
Jackson, MS 39216-4500
Phone
(601) 984-5200
Fax
(601) 984-2086
NPI assigned
Mar 22, 2016
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 26689 MS Primary

Addresses

Primary practice location

2500 N State St
Department of Pediatrics
Jackson, MS 39216-4500

Mailing address

2500 N State St
Department of Pediatrics
Jackson, MS 39216-4500
Phone (601) 984-5200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191023001744 MS Practitioner - Pediatric Medicine 5991099947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26689MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Aug 5, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Aug 5, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Pediatrics Past Accepting new patients

Locations

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

Interoperability endpoints

  • Direct secure messaging: marlainaberch@magnolia.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1750743670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5200",
            "fax_number": "601-984-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5200",
            "fax_number": "601-984-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCH",
        "first_name": "MARLAINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "26689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.