JACKSON ORTHOPAEDIC CLINIC, PA
NPI 1215084967
Orthopaedic Surgery in Jackson, MS

Active since January 04, 2007
971 LAKELAND DR, SUITE 950, JACKSON, MS 39216(601) 981-7212 Get Directions Write a Review

NPPES record last updated: April 8, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jackson Orthopaedic Clinic, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON ORTHOPAEDIC CLINIC, PA (NPI 1215084967) is a healthcare organization registered as an orthopaedic surgery in Jackson, Mississippi and active in the NPI registry since January 2007. The organization lists David J Gandy, President, as its authorized official.

NPPES Registry Identity

NPI1215084967
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameJACKSON ORTHOPAEDIC CLINIC, PA
Location Address971 LAKELAND DR, SUITE 950Jackson, MS 39216-4643
Mailing Address971 Lakeland Dr, Suite 950Jackson, MS 39216-4643 · (601) 981-7212
Organization SubpartNo
Authorized OfficialDavid J GandyPresident · (601) 981-7212
Enumeration DateJanuary 4, 2007
Last NPPES UpdateApril 8, 2013
✔ NPI 1215084967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MS · 07306
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
971 LAKELAND DR, Jackson, MS 39216

Other Identifiers 2

Medicare ID-Type UnspecifiedC03010MS
Medicaid00280226MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Orthopaedic Clinic, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Orthopaedic Clinic, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Orthopedic Surgery
NPI 1114934643
401 BAPTIST DR STE 301
Madison, MS 39110
(601) 973-1571
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Orthopaedic Clinic, PA's NPI number?

The NPI number for Jackson Orthopaedic Clinic, PA is 1215084967. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is Jackson Orthopaedic Clinic, PA located?

Jackson Orthopaedic Clinic, PA is located at 971 Lakeland Dr Suite 950, Jackson, MS 39216. The listed phone number is (601) 981-7212.

What is Jackson Orthopaedic Clinic, PA's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Jackson Orthopaedic Clinic, PA enrolled in Medicare?

Yes. Jackson Orthopaedic Clinic, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Orthopaedic Clinic, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Jackson Orthopaedic Clinic, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jackson Orthopaedic Clinic, PA was last updated on April 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.