Jennifer L Grisham, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19348 Issued in MS

Practice address

1573 Medical Park Cir
Tupelo, MS 38801-6580

Phone

(662) 844-9885

Fax

(662) 842-1350

NPI assigned

Sep 14, 2006

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 identifiers 1

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifergrisham@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Center Inc

  dba Behavioral Health Center

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347
  Medicare reassignment NPD
• North Mississippi Medcial Center, Inc.

  dba Radiology Consultants

  • Diagnostic Radiology Physician
  • Tupelo, MS
  • NPI 1902762487
  NPD
• North Mississippi Medical Center Inc.

  dba Neurology Hospitalists

  • Neurology Physician
  • Tupelo, MS
  • NPI 1417357427
  NPD
• Amory Surgery Clinic, PLLC

  dba Amory Surgery Clinic

  • Surgery Physician
  • Amory, MS
  • NPI 1821441080
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1952406589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016580",
            "telephone_number": "662-844-9885",
            "fax_number": "662-842-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016580",
            "telephone_number": "662-844-9885",
            "fax_number": "662-842-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "19348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06085766",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis Greer, MD
• Bryanna Grice
• Jessica N Griffin, CFNP
• Toya Griffin, MSW/CMHT
• Donna Grisham
• Richard Dwight Griswold, M.D.
• Anna K Groff Ford, OTR/L
• Kellie Grove, MSN, FNP-C
• Growth Counseling PLLC
• Emalee Gullick, NP

• Pediatrics Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.