Active NPI
Judy Gearhart, M.D.
- Family Medicine Physician
- Jackson, MS
National Provider Identifier
1780770883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 09122
- Practice address
- 878 Lakeland Dr
Jackson, MS 39216-4644 - Phone
- (601) 984-6800
- Fax
- (601) 984-6811
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 09122 | MS | Primary |
Addresses
Primary practice location
878 Lakeland Dr
Jackson, MS 39216-4644
Mailing address
PO Box 4999
Jackson, MS 39296-4999
Phone (601) 984-6800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0112688 | Medicaid | MS | |
| P00641631 | Other | MS | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09122 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Family Medicine Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Jackson, MS
- NPI 1396846648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1780770883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4999",
"city": "JACKSON",
"state": "MS",
"postal_code": "392964999",
"telephone_number": "601-984-6800",
"fax_number": "601-984-6811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "878 LAKELAND DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164644",
"telephone_number": "601-984-6800",
"fax_number": "601-984-6811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEARHART",
"first_name": "JUDY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "09122",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0112688",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00641631",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.