| Traditions Health | |
|
680 Highway 51 Ste L Ridgeland MS 39157-2103 | |
| (601) 317-4947 | |
| Not Available |
| Full Name | Traditions Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 680 Highway 51 Ste L, Ridgeland, Mississippi |
| Authorized Official Name and Position | John R Kerndl (CFO & SECRETARY) |
| Authorized Official Contact | 9797046547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Health 6840 Carothers Pkwy Ste 550 Franklin TN 37067-8002 Ph: (979) 704-4657 | Traditions Health 680 Highway 51 Ste L Ridgeland MS 39157-2103 Ph: (601) 317-4947 |
| NPI Number | 1386242097 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 06/14/2024 |
| Medicare PECOS PAC ID | 5597175604 |
|---|---|
| Medicare Enrollment ID | O20201217001483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386242097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Eric M Reiners |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396057618 PECOS PAC ID: 3577704360 Enrollment ID: I20130719000604 |
| Provider Name | Sara Nicole Burwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063840148 PECOS PAC ID: 0345477063 Enrollment ID: I20131228000174 |
| Provider Name | Sarah K Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689003873 PECOS PAC ID: 5193954477 Enrollment ID: I20140207000728 |
| Provider Name | Jennifer Foreman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003281916 PECOS PAC ID: 5193023034 Enrollment ID: I20160411000818 |
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