NPIMap

Individual provider Active NPI

Grant Jernigan

  • Hospitalist Physician
  • Gulfport, MS
National Provider Identifier
1801390877
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
28346 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 575-1194
NPI assigned
Mar 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28346 MS
Hospitalist Physician 208M00000X 28346 MS Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

4500 13TH St
Gulfport, MS 39501-2515
Phone (318) 348-4255

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
I20210804001658 MS Practitioner - Internal Medicine 1759631914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

1440 Central Ave E
Wiggins, MS 39577-9602
Phone (601) 928-6700

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28346MSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2021 Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Biloxi Hma LLC Past Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

  • Direct secure messaging: gjernigan@direct.mhg.com

Organizations & group practices 7

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1801390877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "318-348-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "28346",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "28346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.