| Medserve, Pa | |
|
Manhattan Nursing And Rehabilitation Center 4540 Manhattan Rd Jackson MS 39206 | |
| (601) 206-0901 | |
| (888) 240-6288 |
| Full Name | Medserve, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | Manhattan Nursing And Rehabilitation Center, Jackson, Mississippi |
| Authorized Official Name and Position | Todd L Fulcher (PHYSICIAN, OWNER) |
| Authorized Official Contact | 6012060901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medserve, Pa 200 Amity Ln Brandon MS 39047 Ph: (601) 206-0901 | Medserve, Pa Manhattan Nursing And Rehabilitation Center 4540 Manhattan Rd Jackson MS 39206 Ph: (601) 206-0901 |
| NPI Number | 1871883223 |
|---|---|
| Provider Enumeration Date | 04/19/2011 |
| Last Update Date | 01/13/2022 |
| Medicare PECOS PAC ID | 8628253978 |
|---|---|
| Medicare Enrollment ID | O20110429000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871883223 | NPI | - | NPPES |
| 05675311 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 12503 (Mississippi) | Primary |
| Provider Name | Todd Larue Fulcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124097191 PECOS PAC ID: 5092600742 Enrollment ID: I20040220000250 |
| Provider Name | Carey Mccarter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568421675 PECOS PAC ID: 8628044120 Enrollment ID: I20040907000707 |
| Provider Name | Sueanne M Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508806308 PECOS PAC ID: 0244296143 Enrollment ID: I20041202000512 |
| Provider Name | Daphenia Knight-starling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922394469 PECOS PAC ID: 5890965107 Enrollment ID: I20110824000321 |
| Provider Name | Sara Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083852131 PECOS PAC ID: 2769654573 Enrollment ID: I20111019000975 |
| Provider Name | Amy C Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770864381 PECOS PAC ID: 0547417073 Enrollment ID: I20120905000662 |
| Provider Name | Jordan Larue Fulcher Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922577378 PECOS PAC ID: 1052656972 Enrollment ID: I20181221000755 |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |