Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jay G Shake, MD

Individual provider Vascular Surgery Physician · NPI 1215967500

Dr. Jay G Shake, MD is a Thoracic Surgery in Jackson, Mississippi. Graduated from University of Minnesota Medical School in 1997, 29 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Minnesota, Mississippi and Texas.

Years since qualifying
29
Trained at
University of Minnesota Medical School
Licensed in
MN, MS, TX
In the registry since
2006
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-5100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 23449 (MS)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 102316 (MN)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence N8723 (TX)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence N8723 (TX)

Record details

NPI number1215967500
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 3, 2006
Last updated in NPPESMay 12, 2015
Mailing address2500 N State St, Jackson, MS 39216-4500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyTHORACIC SURGERY
Also practisesGENERAL SURGERY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 1997 (29 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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