NPIMap

Organization Active NPI

Jefferson County Hospital

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Fayette, MS
National Provider Identifier
1780894253
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
14721 Issued in MS
Legal business name
JEFFERSON COUNTY HOSPITAL
Practice address
870 Main Street
Fayette, MS 39069
Phone
(601) 786-3401
Fax
(601) 786-3400
NPI assigned
May 23, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Jerry Kennedy
Title
Administrator
Phone
(601) 786-3401

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14997 MS
Family Medicine Physician 207Q00000X 07965 MS
Internal Medicine Physician 207R00000X 16670 MS
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 14721 MS Primary

Addresses

Primary practice location

870 Main Street
Fayette, MS 39069

Mailing address

870 Main Street
Fayette, MS 39069
Phone (601) 786-3401

Other names 1

  • Jefferson County Hospital ER Physician Claims Other name

National Provider Directory

National Provider Directory
Tax ID family
Heart Station Ekg Servi3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1780894253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 MAIN STREET",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "39069",
            "telephone_number": "601-786-3401",
            "fax_number": "601-786-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MAIN STREET",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "39069",
            "telephone_number": "601-786-3401",
            "fax_number": "601-786-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-786-3401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "14997",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "07965",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16670",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MS",
            "license": "14721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson County Hospital ER Physician Claims",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayette, 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.

Verify at the official NPI Registry.