NPIMap

Individual provider Active NPI

Renie Jordon, M. D.

  • Internal Medicine Physician
  • McComb, MS
National Provider Identifier
1962451294
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14640 Issued in MS
Practice address
1506 Aston Ave
McComb, MS 39648-2735
Phone
(601) 249-4415
Fax
(601) 249-4474
NPI assigned
May 5, 2006
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14640 MS Primary

Addresses

Primary practice location

1506 Aston Ave
McComb, MS 39648-2735

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other practice location 1

200 Marion Ave
McComb, MS 39648-2706
Phone (601) 250-4381

Other identifiers 1

IdentifierTypeStateIssuer
00116649MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922000236 MS Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Emergency Medicine 9537137161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1506 Aston Ave
McComb, MS 39648-2735
Phone (601) 249-4415

205 Marion Ave
McComb, MS 39648-2705
Phone (601) 684-9116

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-1382

300 Rawls Dr
McComb, MS 39648-2877
Phone (601) 684-2481

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Medical Services of Ms, Inc CurrentSince Nov 16, 2007 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
Marion General Hospital Past Accepting new patients
SE Mississippi Emergency Physicians LLC Past Accepting new patients
Southwest Ms Regional Medical Center Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

233 Magnolia St
Hazlehurst, MS 39083
Phone (601) 894-4541

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

200 Marion Ave
McComb, MS 39648
Phone (601) 250-4381

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1962451294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482735",
            "telephone_number": "601-249-4415",
            "fax_number": "601-249-4474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482706",
            "country_code": "US",
            "telephone_number": "601-250-4381",
            "fax_number": "601-250-4367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDON",
        "first_name": "RENIE",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "14640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116649",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.