Individual provider Active NPI

Jessie Ann George, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1881606440
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13439R Issued in LA
Practice address
1190 N State St
Suite 204
Jackson, MS 39202-2413
Phone
(601) 973-1624
Fax
(601) 973-1596
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 13439R LA Primary

Addresses

Primary practice location

1190 N State St
Suite 204
Jackson, MS 39202-2413

Mailing address

PO Box 2153
Dept 1947
Birmingham, AL 35287-0002
Phone (601) 944-1717

Other identifiers 1

IdentifierTypeStateIssuer
1431923MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1881606440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153",
            "address_2": "DEPT 1947",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352870002",
            "telephone_number": "601-944-1717",
            "fax_number": "601-944-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 204",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-973-1624",
            "fax_number": "601-973-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JESSIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13439R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1431923",
            "state": "LA"
        }
    ],
    "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 Jun 9, 2016; 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.