Individual provider Active NPI

Jenna C Benge

  • Dermatology Physician
  • Jackson, MS
National Provider Identifier
1942555438
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
T-5583 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5012
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X T-5583 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5012

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250910002061 MS Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9638320344

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-5583MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Healthcare Management, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1942555438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENGE",
        "first_name": "JENNA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "T-5583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.