Individual provider Active NPI

Jenni Kate Miles, MD

  • Family Medicine Physician
  • Kosciusko, MS
National Provider Identifier
1790417251
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32828 Issued in MS
Practice address
332 Highway 12 W
Kosciusko, MS 39090-3209
Phone
(662) 289-1800
Fax
(666) 289-2486
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32828 MS Primary

Addresses

Primary practice location

332 Highway 12 W
Kosciusko, MS 39090-3209

Mailing address

PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100

Other practice location 1

300B South Pearl Street
Carthage, MS 39051-4108
Phone (601) 298-0333

Other practice location 2

530 Veterans Memorial Dr
Kosciusko, MS 39090-3858
Phone (662) 289-9155

Other practice location 3

59 Montague St
Goodman, MS 39079-9011
Phone (662) 739-6040

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
I20250908001377 MS Practitioner - Family Practice 9830571421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

332 Hwy 12 W
Kosciusko, MS 39090-3209
Phone (662) 289-1800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of Mississippi LLC CurrentSince Aug 4, 2025 Accepting new patients
Premier Medical Group of Mississippi LLC PastSince Jul 22, 2025 Accepting new patients
Attala Community Care Center LLC Past Accepting new patients

Locations

300 S Pearl St
#B
Carthage, MS 39051
Phone (601) 298-0333

59 Montague St
Goodman, MS 39079
Phone (662) 739-6040

332 Highway 12 W
Kosciusko, MS 39090
Phone (601) 206-6100

530 Veterans Memorial Dr
Kosciusko, MS 39090
Phone (662) 289-9155

Interoperability endpoints

  • Direct secure messaging: jenni.miles.1@27768.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1790417251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-1800",
            "fax_number": "666-289-2486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300B South Pearl Street",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MS",
            "postal_code": "390514108",
            "country_code": "US",
            "telephone_number": "601-298-0333",
            "fax_number": "601-298-0797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 Veterans Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Kosciusko",
            "state": "MS",
            "postal_code": "390903858",
            "country_code": "US",
            "telephone_number": "662-289-9155",
            "fax_number": "662-289-7752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "59 Montague St",
            "address_purpose": "LOCATION",
            "city": "Goodman",
            "state": "MS",
            "postal_code": "390799011",
            "country_code": "US",
            "telephone_number": "662-739-6040",
            "fax_number": "662-739-6041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES",
        "first_name": "JENNI",
        "middle_name": "KATE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "32828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

Verify at the official NPI Registry.