|
| |
|
3531 Lakeland Dr Jackson MS 39232-8049 | |
| (601) 955-2656 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3531 Lakeland Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Sagar H Patel (OWNER/MD) |
| Authorized Official Contact | 6019552656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2862 Ridgeland MS 39158-2862 Ph: (601) 955-2656 | 3531 Lakeland Dr Jackson MS 39232-8049 Ph: (601) 955-2656 |
| NPI Number | 1255818076 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 7810223559 |
|---|---|
| Medicare Enrollment ID | O20190801002412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255818076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Mississippi) | Primary |
| Provider Name | Sagar H Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386725570 PECOS PAC ID: 8325115959 Enrollment ID: I20080924000391 |
| Provider Name | Deidra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585286 PECOS PAC ID: 7618260647 Enrollment ID: I20160727002573 |
| Provider Name | Nancy Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871944652 PECOS PAC ID: 3173809605 Enrollment ID: I20170417000713 |
| Provider Name | Jennifer Linette Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821597691 PECOS PAC ID: 2769836535 Enrollment ID: I20230927002755 |
| Provider Name | Amanda D. Nason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396292033 PECOS PAC ID: 4981059011 Enrollment ID: I20231010003114 |
| Provider Name | Monica Nicole Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437935251 PECOS PAC ID: 5698206258 Enrollment ID: I20241007002384 |
Gifted Futures Ms Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6040 I-55 North Frontage Rd., Jackson, MS 39211 Phone: 929-466-1305 | |
1st Priority Healthcare Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 River Ridge Dr, Suite 102, Jackson, MS 39216 Phone: 252-315-5165 Fax: 888-376-1118 | |
Marion Counseling Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Briarwood Dr Ste 510, Jackson, MS 39206 Phone: 601-956-4816 Fax: 601-956-4816 | |
Ridgewood Clinics Pa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1059 Ridgewood Clinic, Jackson, MS 39211 Phone: 601-957-3211 Fax: 601-957-9753 | |