Justice Aaron Gondwe, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

20373 Issued in MS

Practice address

965 J K Avent Dr
Suite 106
Grenada, MS 38901-5045

Phone

(662) 227-6450

Fax

(662) 227-6452

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Grenada Adult Healthcare Clinic PC.

  • Primary Care Clinic/Center
  • Grenada, MS
  • NPI 1144478512
  Medicare reassignment Authorized official
• 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

  • General Acute Care Hospital
  • Grenada, MS
  • NPI 1720419583
  Medicare reassignment NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1700349222
  Medicare reassignment NPD
• Access Healthcare Clinic LTD

  • Medical Specialty Clinic/Center
  • East Moline, IL
  • NPI 1407835200
  NPD (past) Authorized official
• State of Mississippi - University of Mississippi Medical Center

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

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Acute Care Hospital
  • Batesville, MS
  • NPI 1053873307
  NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1366905028
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1912928086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 JK AVENT DRIVE",
            "address_2": "SUITE 106",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "38901",
            "telephone_number": "662-227-6450",
            "fax_number": "662-227-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 J K AVENT DR",
            "address_2": "SUITE 106",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015045",
            "telephone_number": "662-227-6450",
            "fax_number": "662-227-6452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Southcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714739",
            "country_code": "US",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDWE",
        "first_name": "JUSTICE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "20373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25140",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3116087",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0491951",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Franklin, FNP-C
• Sarah Katherine Gantz Pannel, D.O
• George M Miller Jr MD PC
• Gibson Pharmacy of Grenada, Inc
• Lillie Gibson, RN
• Goss Mental Health and Wellness PLLC
• Jennifer Lee Goss, FNP
• Grace Health & Rehab of Grenada, LLC
• Grancare, LLC
• Grandcare

• Infectious Disease Physician in Grenada, MS
• Providers in Grenada, MS by specialty
• Infectious Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.

Verify at the official NPI Registry.