NPIMap

Individual provider Active NPI

James Grady Bennett Jr., MD

  • Interventional Cardiology Physician
  • Jackson, MS
National Provider Identifier
1760426670
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
16464 Issued in MS
Practice address
970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635
Phone
(601) 982-7850
Fax
(601) 718-5145
NPI assigned
Jun 15, 2006
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 16464 MS Primary
Cardiovascular Disease Physician 207RC0000X 16464 MS

Addresses

Primary practice location

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635

Mailing address

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635
Phone (601) 982-7850

Other identifiers 1

IdentifierTypeStateIssuer
03650034MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gray.bennett@direct.jacksonheart.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000330 MS Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 7911941455 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Mississippi School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians
St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians
Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 364-6175

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4634
Phone (601) 982-7850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting43
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16464MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center CurrentSince Jun 26, 2022 Accepting new patients
Kings Daughters Medical Center Current Accepting new patients
St. Dominic Jackson Memorial CurrentSince Aug 14, 2009 Accepting new patients
St Dominic Hospital Crna's CurrentSince Aug 14, 2009 Accepting new patients
Jackson Heart Clinic. P.a. Cardiovascular Disease CurrentSince Jul 18, 2005 Accepting new patients
North Sunflower Medical Center CurrentSince Jun 26, 2022 Accepting new patients
King's Daughters Medical Center CurrentSince Mar 1, 2024 Accepting new patients
North Sunflower Medical Center Current Accepting new patients
King's Daughters Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Radiology Services P a Past Accepting new patients
St Dominic-Jackson Memorial Hospital Past Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
Brandon Hma LLC Past Accepting new patients

Locations

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

185 Medical Pkwy
Ste 202
Flowood, MS 39232

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

970 Lakeland Dr
Ste 61
Jackson, MS 39216
Phone (601) 200-2780

326 Commerce Center Dr
Ste 2000
Ridgeland, MS 39157

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1760426670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR",
            "address_2": "SUITE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164635",
            "telephone_number": "601-982-7850",
            "fax_number": "601-718-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR",
            "address_2": "SUITE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164635",
            "telephone_number": "601-982-7850",
            "fax_number": "601-718-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JAMES",
        "middle_name": "GRADY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "16464",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "16464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03650034",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gray.bennett@direct.jacksonheart.nextgenshare.com",
            "affiliation": "N",
            "address_1": "970 Lakeland Dr",
            "address_2": "Suite 61",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.