CARDIAC CIN OF JACKSON LLC (NPI# 1033611009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033611009 |
| Entity Type | Organization |
| Organization Name | CARDIAC CIN OF JACKSON LLC |
| Practice Address |
460 Briarwood Dr Ste 400-5012 Jackson MS 39206-3051 |
| Mailing Address |
102 Woodmont Blvd Ste 350 Nashville TN 37205-2216 |
| Practice Telephone | 6153860064 |
| Mailing Telephone | 6153860064 |
| Mailing Fax Number | 6153860067 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | EDWARD LELAND HUTTON EADIE (DIRECTOR / AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6157332064 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
460 BRIARWOOD DR STE 400-5012 |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-3051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427614916 | Nord Regenerative Sports Medicine, LLC | Orthopaedic Surgery | 2025 Greystone Sq, Jackson, TN 38305-3576 | 2019-05-10 |
| 1760774616 | Nicholas Vance | Orthopaedic Surgery | 569 Skyline Dr Ste 100, Jackson, TN 38301-3911 | 2011-05-11 |
| 1578892972 | L.f.kroner IIi Md PC | Orthopaedic Surgery | 3950 Trail Dr, Jackson, WY 83001-9287 | 2009-12-14 |
| 1972735025 | Sreenivasa Reddy Alla | Orthopaedic Surgery | 726 Highway 11 N, Suite 5, Jackson, KY 41339 | 2009-08-21 |
| 1841411790 | David John Gandy | Orthopaedic Surgery | 971 Lakeland Dr Ste 950, Jackson, MS 39216-4608 | 2007-05-01 |
| 1760521702 | David Khoury Iv | Orthopaedic Surgery | Teton Orthopaedics, 555 E. Broadway, Jackson, WY 83001 | 2007-02-06 |
| 1487720355 | Alabama Orthopaedic Clinic, PC | Orthopaedic Surgery | 220 Hospital Ave, Jackson, AL 36545 | 2006-11-24 |
| 1649341876 | Jackson Orthopaedic Care & Surgery, P.C. | Orthopaedic Surgery | 200 Summit Ave, Suite A, Jackson, MI 49201-2464 | 2006-11-10 |
| 1720157274 | Raymond Hamel Pierson | Orthopaedic Surgery | 813 Court St Ste 1, Jackson, CA 95642-2131 | 2006-11-07 |
| 1952487001 | William C Neal, M.d. Pllc | Orthopaedic Surgery | 945 West Braodway, Suite 202, Jackson, WY 83001-7369 | 2006-10-31 |
| Find all providers in JACKSON | ||||
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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.