Denisse Leticia Staufert Gutierrez, MD

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

31016 Issued in MS

Practice address

4400 Old Canton Rd FL 3
Jackson, MS 39211-5982

Phone

(888) 815-2005

NPI assigned

Jul 4, 2017

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Denisse Staufert-Gutierrez Other name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dstaufertgutierrez191901@ummc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Medical Center-Grenada Specialty Clinic

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD

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

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1912428590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DR STE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565610",
            "telephone_number": "601-984-1000",
            "fax_number": "601-815-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 OLD CANTON RD FL 3",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115982",
            "telephone_number": "888-815-2005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUFERT GUTIERREZ",
        "first_name": "DENISSE",
        "middle_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-04",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MS",
            "license": "31016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISSE",
            "last_name": "STAUFERT-GUTIERREZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Statewide Healthcare Services, Inc
• Statewide Healthcare Services, Inc. (Oxford Healthcare)
• Statewide Healthcare Services, LLC
• Benjamin Statham, DO
• Amanda Stauble, APRN
• Michelle Steadman
• Josephine Cenzalli Steevens, PHARM.D.
• Amanda Kellie Stegall, ACNPC-AG
• Jacob Michael Steiniger
• Step Up Counseling & Consulting

• Developmental - Behavioral Pediatrics Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Developmental - Behavioral Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.

Verify at the official NPI Registry.