Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ANDENET MENGISTU, MD
ActiveDR. ANDENET MENGISTU, MD is a Sports Medicine (IM) healthcare provider located in JACKSON, Mississippi. NPI 1609454024 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · JACKSON, MS
Registration Details
- NPI Number
- 1609454024
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 29, 2021 (5.4127378218178 yrs)
- Last Updated
- Jul 23, 2025
- License
-
T-5943 (MS)
Practice Information
- Address
-
2500 N STATE STJACKSON, MS, 392164500Browse MS providers · Browse ZIP 39216
- Phone
- 6019844820
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
- Additional Specialty
- Student (Health Education/Training)
Other Sports Medicine (IM) Providers in JACKSON, MS
| Name | Credential | NPI |
|---|---|---|
| MOHAMMAD IFTEKHAR ULLAH | MD | 1659355949 |
| DR. DANI CHOUFANI | MD | 1720032436 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.