Active NPI
Jordan B White
- Pediatrics Physician
- Jackson, MS
National Provider Identifier
1861256307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- T-5858
- Practice address
- 4820 Northampton Dr
Jackson, MS 39211-5730 - Phone
- (601) 616-1710
- NPI assigned
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | T-5858 | MS | Primary |
Addresses
Primary practice location
4820 Northampton Dr
Jackson, MS 39211-5730
Mailing address
411 Westport Way
Flowood, MS 39232-7543
Phone (601) 616-1710
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250912000329 | MS | Order and Referring Only - Pediatric Medicine | 5799288098 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1861256307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 WESTPORT WAY",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392327543",
"telephone_number": "601-616-1710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 NORTHAMPTON DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115730",
"telephone_number": "601-616-1710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JORDAN",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "T-5858",
"primary": true
}
],
"identifiers": [],
"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 Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.