Jennifer C Shores

M.D. | Pediatric Cardiology | Female

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Complete Profile:

Jennifer C Shores basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Cardiology
Provider Name :	Jennifer C Shores
Credential :	M.D.
Gender :	Female

Business Address:

Jennifer C Shores address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	2500 N State St Jackson, MS, 39216-4500 United States
Phone Number :	601-984-5250
Fax Number :	601-984-5283

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1568493450
NPI Entity Type :	Individual
First Enrolment Date :	06 Jul, 2006
Last Updated On :	21 Apr, 2014

Medicare Participation:

Jennifer C Shores participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	2466542683
Medicare Enrollment ID :	I20071212000136
Primary Specialty :	Pediatric Medicine
Medical School :	Johns Hopkins University School Of Medicine
Graduation Year :	1993
Accepts Medicare?	Yes. Jennifer C Shores accepts medicare insurance.

Group Practice Association:

Jennifer C Shores is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Jennifer C Shores is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
State Of Mississippi - University Of Mississippi Medical Center	1850293036	828	965 Avent Dr Grenada, MS - 389015045 Ph: 6622277444	Yes
State Of Mississippi - University Of Mississippi Medical Center	1850293036	828	2500 N State St Jackson, MS - 392164500 Ph: 6018984404	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jennifer C Shores are as mentioned. Primary taxonomy code for Jennifer C Shores, M.D. is 2080P0202X (Pediatrics Pediatric Cardiology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0202X	Pediatrics Pediatric Cardiology	Yes	17022	MS

Legacy Identifiers:

Other legacy medical identifiers of Jennifer C Shores such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
158189	MEDICAID	AL
0123172	MEDICAID	MS

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	2500 N State St Jackson, MS, 39216-4500 United States
Phone Number :	601-984-5250
Fax Number :	601-984-5283

Business Location:

Patients can refer following map for directions to Jennifer C Shores practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.