Active NPI
Jessie Ann George, M.D.
- Internal Medicine Physician
- Jackson, MS
National Provider Identifier
1881606440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 13439R
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1431923 | Medicaid | LA |
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.