Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1821852112 Individual Practitioner Female Practitioner

Avery Bouchillon

Internal Medicine • Jackson, MS

Professional Overview & Biography Verified Profile Summary

Avery Bouchillon is a registered healthcare professional specializing in Internal Medicine in Jackson, MS. Practice services are available at 2500 N STATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2500 N State St

Jackson, MS 392164500

Telephone 6627366927
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Jackson, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.8 Yrs
State Avg: 25.2 Yrs
Regional Practice Density
335 Specialists

Practicing in Jackson, MS (1017 Statewide)

Telehealth Adoption Rate
3.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-01
Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MS T-5841

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Lamar Davis , MD

Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology

NPI 1003006206

Doctor of Medicine (M.D.)

NPI 1003014606

Doctor of Medicine (M.D.)

NPI 1003062605

Doctor of Medicine (M.D.)

Dr. Mary Kinney Corley , MD

Obstetrics & Gynecology

NPI 1003070863

Doctor of Medicine (M.D.)

Dr. Laura Vearrier , MD

Emergency Medicine

NPI 1003076035

Doctor of Medicine (M.D.)

NPI 1003103342

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location March 31, 2025

Registered at 2500 N STATE ST, JACKSON, MS 392164500 (Tel: 6627366927)

📍
Updated Business Mailing Address March 31, 2025

Registered at 2500 N STATE ST, JACKSON, MS 392164500 (Tel: 6019841000)

NPI Profile Active February 07, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location February 07, 2024

Registered at 22325 HIGHWAY 43, ETHEL, MS 390676037 (Tel: 6627366927)

📍
Updated Business Mailing Address February 07, 2024

Registered at 22325 HIGHWAY 43, ETHEL, MS 390676037 (Tel: 6627366927)

👤
Provider Name / Credentials Updated February 07, 2024

Recorded as AVERY BOUCHILLON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 07, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1821852112
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2024
Last Update: July 01, 2025
Sole Proprietor: No

Mailing Address

2500 N State St

Jackson, MS 392164500

Phone: 6019841000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.