MADENA JANE GIBSON (NPI# 1013431519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013431519 |
Entity Type | Individual |
Full Name | MADENA JANE GIBSON |
Credential | MD |
Practice Address |
1695 Moses Rd Raymond MS 39154-8766 |
Practice Telephone | (601) 857-8638 |
Mailing Telephone | 6018578638 |
Enumeration Date | 2017-07-27 |
Last Update Date | 2017-07-27 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | 07981 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | MS MEDICAL LICENSURE | 07981 | 01 |
Street Address |
1695 MOSES RD |
City | RAYMOND |
State | MS |
Zip Code | 39154-8766 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649520446 | Katherine Gaynell Garrison | Nurse Anesthetist, Certified Registered | 214 Port Gibson St, Raymond, MS 39154 | 2012-09-19 |
1194938126 | Hiram Alfonso Gatewood Jr. | Dentist | 450 Main St., Raymond, MS 39154 | 2007-05-07 |
1275745432 | Hinds County School District | Registered Nurse | 417 Palestine Road, Raymond, MS 39154 | 2007-05-03 |
1154418655 | First Family Healthcare Center, Pllc | Family Medicine | 119 South Oak Street, Ste 2, Raymond, MS 39154 | 2006-10-06 |
1558503698 | Martha Michelle Chambers | Nurse Practitioner | 119 South Oak Street, Suite 2, Raymond, MS 39154 | 2009-04-06 |
1225259583 | Trucare Hospice, LLC | Hospice Care, Community Based | 120 West Main St, Suite B, Raymond, MS 39154 | 2007-05-02 |
1063593283 | Tranquility Hospice | Hospice Care, Community Based | 120 West Main St, Raymond, MS 39154 | 2006-10-17 |
1932314192 | Raymond Drug Store,inc. | Pharmacy | 112 W.main St., Raymond, MS 39154-1205 | 2007-05-11 |
1669575627 | Minor Med Care, P.a. | Clinic/Center | 120 W Main St, Raymond, MS 39154-1223 | 2006-09-06 |
1548720568 | First Choice Family Healthcare Clinic Pllc | Clinic/Center | 119 S Oak Ste 2, Raymond, MS 39154-4205 | 2019-03-25 |
Find all providers in zip 39154 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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---|---|---|---|---|
1033342720 | Perry Joe Wise | General Practice | 723 Ballentine St, Raymond, WA 98577-3603 | 2009-08-27 |
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1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.