Individual provider Active NPI

Mary Garrard Whitehead, CCC-SLP

  • Speech-Language Pathologist
  • Jackson, MS
National Provider Identifier
1982381059
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5087 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-6882
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5087 MS Primary

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

50 N Acres Dr
Jackson, TN 38301-3414
Phone (731) 499-4126

Other practice location 1

1200 N State St Ste 210
Jackson, MS 39202-2000
Phone (601) 714-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921003849 MS Practitioner - Qualified Speech Language Pathologist 7517311756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 Baptist Dr
Suite 306
Madison, MS 39110-2012
Phone (601) 607-7204

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5087MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Medical Foundation of Central Ms CurrentSince Jul 24, 2023 Accepting new patients

Locations

108 Clinton Pkwy
Clinton, MS 39056
Phone (601) 926-2018

151 E Metro Dr
Ste 106
Flowood, MS 39232
Phone (601) 664-7191

102 Lexington Dr
#100
Gluckstadt, MS 39110
Phone (601) 973-1688

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

7273 S Siwell Rd
Jackson, MS 39272
Phone (601) 372-8223

1200 N State St
Ste 210
Jackson, MS 39202
Phone (601) 714-3202

401 Baptist Dr
Ste 306
Madison, MS 39110
Phone (601) 607-7204

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Organizations & group practices 2

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": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1982381059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N ACRES DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013414",
            "telephone_number": "731-499-4126",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-6882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022000",
            "country_code": "US",
            "telephone_number": "601-714-3202",
            "fax_number": "601-714-3416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "MARY",
        "middle_name": "GARRARD",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "5087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.