NPIMap

Individual provider Active NPI

Nurudeen Shekoni, MD

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1841347770
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14516 Issued in MS
Practice address
5160 Galaxie Dr
Jackson, MS 39206-4308
Phone
(601) 713-0890
Fax
(601) 366-3415
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14516 MS Primary

Addresses

Primary practice location

5160 Galaxie Dr
Jackson, MS 39206-4308

Mailing address

PO Box 4522
Jackson, MS 39296-4522
Phone (601) 713-0890

Other identifiers 1

IdentifierTypeStateIssuer
00115572MedicaidMS

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
I20100729000122 MS Practitioner - Internal Medicine 7012040926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Jackson Medical Clinic PLLCGroup PAC ID 4082715354, 2 clinicians

Practice addresses (Care Compare)

5160 Galaxie Dr
Jackson, MS 39206-4308
Phone (601) 713-0890

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.28 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
57.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Jackson Medical Clinic PLLC Internal Medicine CurrentSince Sep 28, 1999 Accepting new patients
Mississippi Baptist Medical Center, Inc. Past Accepting new patients
St Dominic-Jackson Memorial Hospital Past Accepting new patients

Locations

5160 Galaxie Dr
Jackson, MS 39206
Phone (601) 713-0890

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: nshekoni150427@direct.bmhcc.org
  • Direct secure messaging: n.shekoni.p1@direct.northjacksonmedical.nextgenshare.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 7

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1841347770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4522",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964522",
            "telephone_number": "601-713-0890",
            "fax_number": "601-366-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 GALAXIE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064308",
            "telephone_number": "601-713-0890",
            "fax_number": "601-366-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKONI",
        "first_name": "NURUDEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "14516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115572",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.