| Mbmc - Neuro Hospitalists | |
|
1225 N State St Jackson MS 39202-2064 | |
| (601) 968-1362 | |
| (601) 292-4592 |
| Full Name | Mbmc - Neuro Hospitalists |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1225 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/ CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbmc - Neuro Hospitalists 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: () - | Mbmc - Neuro Hospitalists 1225 N State St Jackson MS 39202-2064 Ph: (601) 968-1362 |
| NPI Number | 1467589556 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 9234026600 |
|---|---|
| Medicare Enrollment ID | O20110707000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467589556 | NPI | - | NPPES |
| 09014368 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Nanette A Ballard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356367312 PECOS PAC ID: 0143123364 Enrollment ID: I20040130000451 |
| Provider Name | Mark O Rester |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538140512 PECOS PAC ID: 8820989205 Enrollment ID: I20040324000179 |
| Provider Name | Harold R Nichols |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699726158 PECOS PAC ID: 3375536592 Enrollment ID: I20040405001055 |
| Provider Name | Joseph A Kwentus |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1477582096 PECOS PAC ID: 3678567245 Enrollment ID: I20040414001441 |
| Provider Name | Jodi M Stubbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720193675 PECOS PAC ID: 2466449319 Enrollment ID: I20040430000614 |
| Provider Name | Michael S Hogue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619943503 PECOS PAC ID: 2860472404 Enrollment ID: I20040723000147 |
| Provider Name | Zina D Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134158579 PECOS PAC ID: 5193798916 Enrollment ID: I20040818001063 |
| Provider Name | William H Jones |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1245341726 PECOS PAC ID: 1254308885 Enrollment ID: I20040914000352 |
| Provider Name | Tauqeer Yousuf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467462879 PECOS PAC ID: 1355301086 Enrollment ID: I20041015000871 |
| Provider Name | Matthew T Gaines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205802667 PECOS PAC ID: 0840251294 Enrollment ID: I20041020000330 |
| Provider Name | Nancy L Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558432005 PECOS PAC ID: 0547222622 Enrollment ID: I20041101000596 |
| Provider Name | Eniola O Otuseso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962451757 PECOS PAC ID: 6608836952 Enrollment ID: I20041216000662 |
| Provider Name | Howard R Holaday |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790795110 PECOS PAC ID: 3971555830 Enrollment ID: I20050218000516 |
| Provider Name | Salvador Arceo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831148972 PECOS PAC ID: 4082655725 Enrollment ID: I20050512000783 |
| Provider Name | Jerry M Sheppard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649280983 PECOS PAC ID: 6608801048 Enrollment ID: I20051004000864 |
| Provider Name | Kenneth C Ball |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770593014 PECOS PAC ID: 6002831237 Enrollment ID: I20051006000967 |
| Provider Name | Elizabeth Ann Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205844537 PECOS PAC ID: 1153343132 Enrollment ID: I20051220000156 |
| Provider Name | Ehsan-ullah Khan Durrani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144253626 PECOS PAC ID: 1658341755 Enrollment ID: I20060421000460 |
| Provider Name | Katheryn N Del Castillo-arceo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609945716 PECOS PAC ID: 5294745881 Enrollment ID: I20060426000789 |
| Provider Name | James G Burnham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881644367 PECOS PAC ID: 6608870704 Enrollment ID: I20060901000252 |
| Provider Name | Cameron Guild |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1396771366 PECOS PAC ID: 2668476425 Enrollment ID: I20060908000447 |
| Provider Name | Eric A Mcvey |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467433995 PECOS PAC ID: 1951296219 Enrollment ID: I20060926000538 |
| Provider Name | Ladean J Livingston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992726137 PECOS PAC ID: 4183620354 Enrollment ID: I20061011000199 |
| Provider Name | David N Duddleston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003840539 PECOS PAC ID: 0143228775 Enrollment ID: I20061115000247 |
| Provider Name | Kristen Bevill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841315546 PECOS PAC ID: 0244339430 Enrollment ID: I20070629000077 |
| Provider Name | Keith D Thorne |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467559476 PECOS PAC ID: 8729171905 Enrollment ID: I20070904000412 |
| Provider Name | Anamaria Andrei |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285829200 PECOS PAC ID: 7416044045 Enrollment ID: I20071030000205 |
| Provider Name | Christina L Barlow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043244510 PECOS PAC ID: 4385732866 Enrollment ID: I20071116000244 |
| Provider Name | Steven A. Bigler |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396776258 PECOS PAC ID: 8426145145 Enrollment ID: I20071127000424 |
| Provider Name | Jennifer F Rhea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568651289 PECOS PAC ID: 1153405550 Enrollment ID: I20080225000131 |
| Provider Name | Carrie Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790907707 PECOS PAC ID: 7214011642 Enrollment ID: I20080225000363 |
| Provider Name | Frank Criddle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447279526 PECOS PAC ID: 6204910052 Enrollment ID: I20080303000682 |
| Provider Name | Amanda K Purser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689876864 PECOS PAC ID: 8628154671 Enrollment ID: I20080401000085 |
| Provider Name | Todd A Clayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386621936 PECOS PAC ID: 1951471960 Enrollment ID: I20080604000042 |
| Provider Name | Gordon Delashmet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538104757 PECOS PAC ID: 3375623549 Enrollment ID: I20080605000851 |
| Provider Name | Henry C Waterer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326064601 PECOS PAC ID: 3779653340 Enrollment ID: I20080609000506 |
| Provider Name | Helen Denise Gipson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164616058 PECOS PAC ID: 2062583362 Enrollment ID: I20080613000258 |
| Provider Name | Stephen H Hindman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508885435 PECOS PAC ID: 1355412529 Enrollment ID: I20080616000226 |
| Provider Name | Meredith H Covington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821186917 PECOS PAC ID: 5395847636 Enrollment ID: I20080616000618 |
| Provider Name | Steven R Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629243530 PECOS PAC ID: 7719059211 Enrollment ID: I20080627000278 |
| Provider Name | Keith O Jones |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316131568 PECOS PAC ID: 3375615669 Enrollment ID: I20080701000523 |
| Provider Name | James L Warnock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356360119 PECOS PAC ID: 1254415698 Enrollment ID: I20080708000362 |
| Provider Name | Bret J Barrett |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1265640577 PECOS PAC ID: 3779657960 Enrollment ID: I20080806000375 |
| Provider Name | Frazier Earl Fyke |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1780609362 PECOS PAC ID: 4284714452 Enrollment ID: I20080806000447 |
| Provider Name | Susan B Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003835885 PECOS PAC ID: 3870668320 Enrollment ID: I20080818000381 |
| Provider Name | William S Horsley |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1841341369 PECOS PAC ID: 0143396010 Enrollment ID: I20080829000515 |
| Provider Name | William J Harris |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1912058520 PECOS PAC ID: 6901972793 Enrollment ID: I20080902000170 |
| Provider Name | John A Bellan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609883446 PECOS PAC ID: 1254408818 Enrollment ID: I20080923000631 |
| Provider Name | Alfredo H Figueroa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134236128 PECOS PAC ID: 0840367405 Enrollment ID: I20080923000680 |
| Provider Name | Michael R Byers |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346311982 PECOS PAC ID: 0244121986 Enrollment ID: I20080925000304 |
| Provider Name | Gina B Burge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184879439 PECOS PAC ID: 3476619651 Enrollment ID: I20090313000265 |
| Provider Name | John L Cross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770794695 PECOS PAC ID: 5890846745 Enrollment ID: I20090706000501 |
| Provider Name | Lynne C Currie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922147123 PECOS PAC ID: 3274688320 Enrollment ID: I20090826000291 |
| Provider Name | Craig V Adams |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1114969011 PECOS PAC ID: 5193728905 Enrollment ID: I20090827000603 |
| Provider Name | William T Williams |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760564660 PECOS PAC ID: 0042356107 Enrollment ID: I20091005000306 |
| Provider Name | Rosalind Hammond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598982993 PECOS PAC ID: 4789721812 Enrollment ID: I20091022000332 |
| Provider Name | Jimmy V Wolfe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093791220 PECOS PAC ID: 7810953478 Enrollment ID: I20091202000269 |
| Provider Name | Anesha M Cowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760661821 PECOS PAC ID: 9234219494 Enrollment ID: I20100205000606 |
| Provider Name | Jeffrey A Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497710685 PECOS PAC ID: 5496884033 Enrollment ID: I20100520000272 |
| Provider Name | Katherine M Jett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407854938 PECOS PAC ID: 9234118084 Enrollment ID: I20100622000802 |
| Provider Name | Albert Michael Koury |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1225143910 PECOS PAC ID: 3678607918 Enrollment ID: I20100823000355 |
| Provider Name | James M Bensler |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1457591570 PECOS PAC ID: 5597959668 Enrollment ID: I20101102001350 |
| Provider Name | Jeffrey Leduff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912079161 PECOS PAC ID: 5890981005 Enrollment ID: I20101130001216 |
| Provider Name | Paul Douglas Vanlandingham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992877047 PECOS PAC ID: 1557557642 Enrollment ID: I20101201000906 |
| Provider Name | Donna A Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932272200 PECOS PAC ID: 5991991978 Enrollment ID: I20101202000692 |
| Provider Name | Byron Kendall Herpich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164629515 PECOS PAC ID: 6002931839 Enrollment ID: I20110128000153 |
| Provider Name | Mohammad A. Ali |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1679759898 PECOS PAC ID: 8628258654 Enrollment ID: I20110209000233 |
| Provider Name | Michael C Roberson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669508263 PECOS PAC ID: 3375430747 Enrollment ID: I20110512000121 |
| Provider Name | Holland M Addison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396816989 PECOS PAC ID: 3577674464 Enrollment ID: I20110520000678 |
| Provider Name | Kristina D Vaughn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174770168 PECOS PAC ID: 3577735802 Enrollment ID: I20111011000367 |
| Provider Name | April M Sylvia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194013078 PECOS PAC ID: 0941473847 Enrollment ID: I20111108000847 |
| Provider Name | Samuel Peeples |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659443836 PECOS PAC ID: 1759492648 Enrollment ID: I20111114000029 |
| Provider Name | Gina B Seago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952473084 PECOS PAC ID: 5092989822 Enrollment ID: I20111114000283 |
| Provider Name | Stephen Epperson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013902725 PECOS PAC ID: 2668474990 Enrollment ID: I20120417000240 |
| Provider Name | Jenna K Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962777896 PECOS PAC ID: 2668634932 Enrollment ID: I20120502000552 |
| Provider Name | Neal I Shparago |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326121542 PECOS PAC ID: 5193980878 Enrollment ID: I20120702000239 |
| Provider Name | David J Sinclair |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235391046 PECOS PAC ID: 9032368048 Enrollment ID: I20121008000610 |
| Provider Name | Jessica Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760646426 PECOS PAC ID: 7719138163 Enrollment ID: I20121112000075 |
| Provider Name | Sridevi Alla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700016763 PECOS PAC ID: 0345491247 Enrollment ID: I20121126000446 |
| Provider Name | Michael W Foster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528379831 PECOS PAC ID: 6901051739 Enrollment ID: I20130228000546 |
| Provider Name | Kimberly D Apostolidis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023307840 PECOS PAC ID: 3375781354 Enrollment ID: I20130603000625 |
| Provider Name | Shanna A Craven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205178241 PECOS PAC ID: 8022256023 Enrollment ID: I20130604000088 |
| Provider Name | Justin A Qualls |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669784930 PECOS PAC ID: 7113167107 Enrollment ID: I20130716000569 |
| Provider Name | Eric M Reiners |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396057618 PECOS PAC ID: 3577704360 Enrollment ID: I20130719000604 |
| Provider Name | Matthew Kenyon George |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659383297 PECOS PAC ID: 4284531096 Enrollment ID: I20130820000671 |
| Provider Name | Jana Phillips |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477714731 PECOS PAC ID: 5991949166 Enrollment ID: I20130910000818 |
| Provider Name | Sara Shrock Sanders |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1477783850 PECOS PAC ID: 2668607573 Enrollment ID: I20131031000955 |
| Provider Name | Cyril Mark Anara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053660969 PECOS PAC ID: 5496983611 Enrollment ID: I20140116000081 |
| Provider Name | Ayesha Khalid |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679702302 PECOS PAC ID: 0941496848 Enrollment ID: I20140210001619 |
| Provider Name | Angela Vij Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073887501 PECOS PAC ID: 7810149531 Enrollment ID: I20140529002019 |
| Provider Name | Kathleen Boyles Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720497951 PECOS PAC ID: 3870715972 Enrollment ID: I20141105000232 |
| Provider Name | Mary H Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497164446 PECOS PAC ID: 2163644121 Enrollment ID: I20141107000670 |
| Provider Name | Syed B Sadiq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639309685 PECOS PAC ID: 8224250147 Enrollment ID: I20141110000900 |
| Provider Name | Kathryn B Brown |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023362456 PECOS PAC ID: 9234356023 Enrollment ID: I20150116000528 |
| Provider Name | Lyndsey T Dill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336531672 PECOS PAC ID: 1850610874 Enrollment ID: I20150424001014 |
| Provider Name | James Zebedee Whatley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184988594 PECOS PAC ID: 5597083998 Enrollment ID: I20150513000709 |
| Provider Name | Leonidas Arapos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932340379 PECOS PAC ID: 7618001561 Enrollment ID: I20150616000856 |
| Provider Name | James R Ware |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336540715 PECOS PAC ID: 5496069775 Enrollment ID: I20150730012220 |
| Provider Name | Antonella T Marchionna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790180107 PECOS PAC ID: 9436464633 Enrollment ID: I20150818003574 |
| Provider Name | Patrick Ross Thurmond |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275897670 PECOS PAC ID: 4880913193 Enrollment ID: I20150827000823 |
| Provider Name | Jazmine Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659755429 PECOS PAC ID: 4284942962 Enrollment ID: I20150929002576 |
| Provider Name | Yuan Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497002869 PECOS PAC ID: 7113237967 Enrollment ID: I20151105002364 |
| Provider Name | Ka'trevia A Younger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083021984 PECOS PAC ID: 7214247873 Enrollment ID: I20151111000305 |
| Provider Name | Bryce Kincaid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265809685 PECOS PAC ID: 2163732736 Enrollment ID: I20151111000588 |
| Provider Name | Christian A Zegarra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285900563 PECOS PAC ID: 7618277823 Enrollment ID: I20151119001599 |
| Provider Name | Brandi A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316328461 PECOS PAC ID: 4183924939 Enrollment ID: I20151130000904 |
| Provider Name | Ajay R Vongala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194089508 PECOS PAC ID: 9133429764 Enrollment ID: I20151203000378 |
| Provider Name | Sudheer Tangella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124382536 PECOS PAC ID: 8527382415 Enrollment ID: I20151205000078 |
| Provider Name | Jatinder Hothi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598079659 PECOS PAC ID: 6406156967 Enrollment ID: I20151205000147 |
| Provider Name | Alexis Chika Nworah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386901411 PECOS PAC ID: 6002122496 Enrollment ID: I20151207001701 |
| Provider Name | Dixie W Ishee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508057811 PECOS PAC ID: 2062594864 Enrollment ID: I20160114000255 |
| Provider Name | Pegah Hosseini-carroll |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316180870 PECOS PAC ID: 5890095962 Enrollment ID: I20160123000139 |
| Provider Name | Adam Blanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801051925 PECOS PAC ID: 5991009888 Enrollment ID: I20160215000368 |
| Provider Name | Rebecca Lee Cauthen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134589930 PECOS PAC ID: 9638476484 Enrollment ID: I20160323000411 |
| Provider Name | Daniel W Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891153441 PECOS PAC ID: 1759688476 Enrollment ID: I20160324000034 |
| Provider Name | Shawn W Sanders |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629207170 PECOS PAC ID: 1850682220 Enrollment ID: I20160615002597 |
| Provider Name | Stephen D Anderson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508206913 PECOS PAC ID: 0143547281 Enrollment ID: I20160623001424 |
| Provider Name | John M Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447690755 PECOS PAC ID: 9830413723 Enrollment ID: I20160728001137 |
| Provider Name | Laura R Daily |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982961728 PECOS PAC ID: 3678723483 Enrollment ID: I20160802001790 |
| Provider Name | David Charles Pierre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053751370 PECOS PAC ID: 1557685336 Enrollment ID: I20160803001701 |
| Provider Name | Rebecca Pace |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003103516 PECOS PAC ID: 2365736550 Enrollment ID: I20160811000028 |
| Provider Name | Christina Glover |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356638845 PECOS PAC ID: 8123312162 Enrollment ID: I20160813000076 |
| Provider Name | Susan Duong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346415114 PECOS PAC ID: 9436292323 Enrollment ID: I20160829000101 |
| Provider Name | Laura Parks |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1457507592 PECOS PAC ID: 0547481129 Enrollment ID: I20161018001153 |
| Provider Name | Laurie Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962854323 PECOS PAC ID: 5991085458 Enrollment ID: I20161130000094 |
| Provider Name | Rachel P Hearst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811396971 PECOS PAC ID: 8527342393 Enrollment ID: I20170223001235 |
| Provider Name | Jared K Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154686541 PECOS PAC ID: 1355657305 Enrollment ID: I20170405002281 |
| Provider Name | Eric Gavour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821416223 PECOS PAC ID: 1759653165 Enrollment ID: I20170821000404 |
| Provider Name | Kathryn Giardina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790205235 PECOS PAC ID: 5991077083 Enrollment ID: I20170824001629 |
| Provider Name | Menarvia Nixon Gaddis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1407173453 PECOS PAC ID: 8729384185 Enrollment ID: I20170918000220 |
| Provider Name | Nathaniel H Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548672868 PECOS PAC ID: 6305164716 Enrollment ID: I20170927001938 |
| Provider Name | Terica Herron Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720490691 PECOS PAC ID: 7719294487 Enrollment ID: I20180116001314 |
| Provider Name | Fritz R Bech |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1831287242 PECOS PAC ID: 4082700513 Enrollment ID: I20180228002145 |
| Provider Name | Gregory Alphonse Redmann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801822317 PECOS PAC ID: 4880757434 Enrollment ID: I20180514000031 |
| Provider Name | Hope N Holcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932552643 PECOS PAC ID: 4587929575 Enrollment ID: I20180522001263 |
| Provider Name | Kathryn Audell Piburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275828030 PECOS PAC ID: 8123206422 Enrollment ID: I20180709000401 |
| Provider Name | Kimberly Jean Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831681345 PECOS PAC ID: 1456608926 Enrollment ID: I20180716002890 |
| Provider Name | Andrew Q Weeks |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346504768 PECOS PAC ID: 7618224783 Enrollment ID: I20180719003387 |
| Provider Name | Melissa Pender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063989036 PECOS PAC ID: 2264777887 Enrollment ID: I20181228001806 |
| Provider Name | Azniv Azar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1700298411 PECOS PAC ID: 3072865716 Enrollment ID: I20190314000722 |
| Provider Name | Michelle Massad Glorioso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205498243 PECOS PAC ID: 7416285309 Enrollment ID: I20190830001315 |
| Provider Name | Meredith Celeste Boston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467012203 PECOS PAC ID: 3072842780 Enrollment ID: I20190905001935 |
| Provider Name | Hunter Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842426 PECOS PAC ID: 1355670647 Enrollment ID: I20190911003737 |
| Provider Name | David C Marbury |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396164802 PECOS PAC ID: 5799007654 Enrollment ID: I20190916001314 |
| Provider Name | Amanda Stauble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063768331 PECOS PAC ID: 3779814330 Enrollment ID: I20191011001778 |
| Provider Name | Lauren Lanier Guthrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053962068 PECOS PAC ID: 4981036753 Enrollment ID: I20191115001905 |
| Provider Name | Frank Haugland |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1578557013 PECOS PAC ID: 2567439268 Enrollment ID: I20200219001617 |
| Provider Name | Cameron Nicole Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265080584 PECOS PAC ID: 5890124499 Enrollment ID: I20200402001743 |
| Provider Name | Stephen Robert Chow |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558774174 PECOS PAC ID: 1759606866 Enrollment ID: I20200421000523 |
| Provider Name | Rahat M Bhatti |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1831489301 PECOS PAC ID: 7719114586 Enrollment ID: I20200617002698 |
| Provider Name | Matthew Brett Hyatt |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1396156394 PECOS PAC ID: 4789998733 Enrollment ID: I20200630001230 |
| Provider Name | Adrienne W Maier |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1841601861 PECOS PAC ID: 1153673967 Enrollment ID: I20200710001091 |
| Provider Name | Galen A Ohnmacht |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528161619 PECOS PAC ID: 4981706439 Enrollment ID: I20200908001319 |
| Provider Name | Terry Catchings Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548741374 PECOS PAC ID: 4789095928 Enrollment ID: I20201119002040 |
| Provider Name | Eric Michael Holland |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1275951097 PECOS PAC ID: 4688892524 Enrollment ID: I20210601001635 |
| Provider Name | Olushola B Obafemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659804987 PECOS PAC ID: 8628342557 Enrollment ID: I20210708003595 |
| Provider Name | Adam Eric Berman |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1588613194 PECOS PAC ID: 8729051743 Enrollment ID: I20210825004271 |
| Provider Name | David A Johnson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922035104 PECOS PAC ID: 3779673801 Enrollment ID: I20220330003101 |
| Provider Name | Jeremy S White |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104237007 PECOS PAC ID: 3870887730 Enrollment ID: I20220608003209 |
| Provider Name | Marianne Kerut Wilson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255728010 PECOS PAC ID: 6204143076 Enrollment ID: I20220819001601 |
| Provider Name | Maziar Sighary |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1508319815 PECOS PAC ID: 0345626461 Enrollment ID: I20220927002755 |
| Provider Name | Kristen Donald Blakeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184342164 PECOS PAC ID: 5890161434 Enrollment ID: I20221021001870 |
| Provider Name | Lydia Jane Dungan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912367939 PECOS PAC ID: 9931490638 Enrollment ID: I20221031002609 |
| Provider Name | Jessica Harris Templeton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780300376 PECOS PAC ID: 0749658391 Enrollment ID: I20221201002443 |
| Provider Name | Ashley Dorman Brian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518668201 PECOS PAC ID: 7911362884 Enrollment ID: I20230427001865 |
| Provider Name | Dustin K Reed |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1982135562 PECOS PAC ID: 1456621564 Enrollment ID: I20230530002167 |
| Provider Name | Daniel H Kelly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417480831 PECOS PAC ID: 2163788647 Enrollment ID: I20230618000025 |
| Provider Name | Joseph A De Gruy |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750874145 PECOS PAC ID: 9032463732 Enrollment ID: I20230629000126 |
| Provider Name | Kaitlyn Renfrow Chow |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1457849721 PECOS PAC ID: 9638421993 Enrollment ID: I20230705001661 |
| Provider Name | Sydney Nichole West |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255960829 PECOS PAC ID: 8426418732 Enrollment ID: I20230718004281 |
Miracle Care Home Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5120 Galaxie Dr, Suite-b, Jackson, MS 39206 Phone: 601-982-1909 Fax: 601-982-8177 | |
Chandler & Associates Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1900 Dunbarton Dr Ste J, Jackson, MS 39216 Phone: 769-428-1681 Fax: 769-241-5091 | |
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 | |
Guided Steps Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Dunbarton Dr, Suite I, Jackson, MS 39216 Phone: 504-491-0774 Fax: 336-464-2227 | |
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 |