Dr Jennifer Gholson, MD is a medicare enrolled "Family Medicine" physician in Summit, Mississippi. Her current practice location is
804 Robb St, Summit, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 276-7665.
Dr Jennifer Gholson is licensed to practice in Mississippi (license number 17561) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174588834.
Physician's Profile
| Full Name | Dr Jennifer Gholson |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 804 Robb St, Summit, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1174588834
- Provider Enumeration Date: 04/18/2006
- Last Update Date: 06/16/2015
Medicare PECOS Information:
- PECOS PAC ID: 2567487309
- Enrollment ID: I20051011000177
Medical Identifiers
Medical identifiers for Dr Jennifer Gholson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1174588834 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 17561 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jennifer Gholson allows following entities to bill medicare on her behalf.
| Entity Name | Keystone Medical Services Of Ms Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174691059 PECOS PAC ID: 7618075177 Enrollment ID: O20070606000447 |
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| Entity Name | Mississippi State University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225012255 PECOS PAC ID: 1254404320 Enrollment ID: O20080723000051 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jennifer Gholson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Jennifer Gholson, MD Po Box 1268, Summit, MS 39666-1268 Ph: (601) 276-7665 | Dr Jennifer Gholson, MD 804 Robb St, Summit, MS 39666-8291 Ph: (601) 276-7665 |
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