| Right Track Medical Group | |
|
3531 Lakeland Dr Ste 1060 Flowood MS 39232-8016 | |
| (601) 420-7010 | |
| (601) 402-5811 |
| Full Name | Right Track Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3531 Lakeland Dr Ste 1060, Flowood, Mississippi |
| Authorized Official Name and Position | Kimberly Glaveskas (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2145507536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Right Track Medical Group Po Box 306603 Nashville TN 37230-6603 Ph: (601) 420-7010 | Right Track Medical Group 3531 Lakeland Dr Ste 1060 Flowood MS 39232-8016 Ph: (601) 420-7010 |
| NPI Number | 1770717449 |
|---|---|
| Provider Enumeration Date | 05/11/2009 |
| Last Update Date | 10/31/2024 |
| Certification Date | 10/31/2024 |
| Medicare PECOS PAC ID | 4880737626 |
|---|---|
| Medicare Enrollment ID | O20100202000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770717449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 17834 (Mississippi) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mark O Rester |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538140512 PECOS PAC ID: 8820989205 Enrollment ID: I20040324000179 |
| Provider Name | Joseph A Kwentus |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1477582096 PECOS PAC ID: 3678567245 Enrollment ID: I20040414001441 |
| Provider Name | Marshall E Belaga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568492478 PECOS PAC ID: 1951385715 Enrollment ID: I20040622000549 |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | William Dwight Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669586996 PECOS PAC ID: 9830136001 Enrollment ID: I20050411000343 |
| Provider Name | Katherine M Raines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588693634 PECOS PAC ID: 7719903285 Enrollment ID: I20051024000693 |
| Provider Name | Jenee M Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720090715 PECOS PAC ID: 3779687215 Enrollment ID: I20070322000533 |
| Provider Name | Raymundo C Trinanes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487727095 PECOS PAC ID: 9335246727 Enrollment ID: I20070518000530 |
| Provider Name | Kristen Bevill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841315546 PECOS PAC ID: 0244339430 Enrollment ID: I20070629000077 |
| Provider Name | Joann Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053630806 PECOS PAC ID: 5890966642 Enrollment ID: I20110927000694 |
| Provider Name | Ashley T Karel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881989911 PECOS PAC ID: 0941476469 Enrollment ID: I20120105000366 |
| Provider Name | Stella S Culliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821365511 PECOS PAC ID: 1658547815 Enrollment ID: I20120110000574 |
| Provider Name | Joyce C Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053681213 PECOS PAC ID: 8527228162 Enrollment ID: I20120320000164 |
| Provider Name | Chasity L Torrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407110554 PECOS PAC ID: 2365665395 Enrollment ID: I20140521000102 |
| Provider Name | Roderick T Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235472697 PECOS PAC ID: 7810115029 Enrollment ID: I20140902000316 |
| Provider Name | Amy W Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720485600 PECOS PAC ID: 6709106479 Enrollment ID: I20150520000920 |
| Provider Name | Carri Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760905004 PECOS PAC ID: 8022381102 Enrollment ID: I20170912002220 |
| Provider Name | Stacey Kitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114443678 PECOS PAC ID: 5395011175 Enrollment ID: I20171023001906 |
| Provider Name | Angela M Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467971416 PECOS PAC ID: 2062772346 Enrollment ID: I20180206000523 |
| Provider Name | Ebony T Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013420702 PECOS PAC ID: 0840534368 Enrollment ID: I20181210002119 |
| Provider Name | Stephanie W Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588171128 PECOS PAC ID: 0345583498 Enrollment ID: I20190514000615 |
| Provider Name | Frank N Perkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336502921 PECOS PAC ID: 3779879481 Enrollment ID: I20191004000089 |
| Provider Name | Chassity N Vanderford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427607688 PECOS PAC ID: 5294167037 Enrollment ID: I20191115000761 |
| Provider Name | Olivia Day Leber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396486551 PECOS PAC ID: 3971989252 Enrollment ID: I20221011000712 |
| Provider Name | Alison B Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235840778 PECOS PAC ID: 4981051877 Enrollment ID: I20231115000657 |
| Provider Name | Lavinia D Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376584425 PECOS PAC ID: 9739254236 Enrollment ID: I20240105001374 |
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