JUAN MEDAURA (NPI# 1114217189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114217189 |
| Entity Type | Individual |
| Full Name | JUAN MEDAURA |
| Credential | MD |
| Practice Address |
2500 North State Street Division of Nephrology Jackson MS 39216-4500 |
| Mailing Address |
2500 North State Street Dept of Internal Medicine Jackson MS 39216-4500 |
| Practice Telephone | 6019845681 |
| Practice Fax Number | 6019845165 |
| Mailing Telephone | 6019845681 |
| Mailing Fax Number | 6019845165 |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2017-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
24487 | MS | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07624070 | 05 | |
| MS | RAILROAD MEDICARE | P01788687 | 01 |
| Street Address |
2500 NORTH STATE STREET DIVISION OF NEPHROLOGY |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549816 | John Joseph Sheehan Jr. | Internal Medicine | 2500 North State Street, Department of Medicine Division of Digestive Disease, Jackson, MS 39216-4500 | 2005-06-21 |
| 1912520370 | Janna Leigh Williams | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Dept of Emergency Medicine, Jackson, MS 39216 | 2020-05-20 |
| 1609498401 | Chin-qune Oliver Yeung Lai Wah | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216 | 2020-05-14 |
| 1689293250 | Karine Desouza | Family Medicine | 2500 North State Street, Attn: Department of Family Medicine, Jackson, MS 39216 | 2020-04-13 |
| 1225667249 | Mallory Browning | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216-4505 | 2020-04-02 |
| 1912490400 | Alberto Andres Arteaga | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc, Department of Otolaryngology - 5 East, Jackson, MS 39216 | 2018-06-11 |
| 1003309493 | Britton Postlethwaite Beatrous | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc Ent Department - 5east, Jackson, MS 39216 | 2018-06-11 |
| 1750874145 | Joseph Alexander De Gruy | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc Ent Department - 5east, Jackson, MS 39216 | 2018-06-11 |
| 1689161523 | Joshua Phillip Rouhan | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Department of Emergency Medicine, Jackson, MS 39216-4505 | 2018-04-17 |
| 1336660356 | Iram Aman | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216 | 2017-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813506 | Uma Mahesh Reddy Avula | Internal Medicine | 2500 N State St Rm L-504, Jackson, MS 39216-4500 | 2020-08-24 |
| 1649555467 | Cardiac Renal & Vascular Associates PC | Internal Medicine | 5240 Robinson Road Ext, Jackson, MS 39204-4276 | 2011-10-12 |
| 1821151598 | Kavita Luthra | Internal Medicine | 900 E Michigan Ave Ste 104, Jackson, MI 49201-2490 | 2006-12-18 |
| 1801971908 | Murphy S Martin | Internal Medicine | 1513 Lakeland Drive, Suite 200, Jackson, MS 39216 | 2006-10-26 |
| 1033124904 | Sybil F Raju | Internal Medicine | 1400 Woodrow Wilson Avenue, Va Hospital, Jackson, MS 39216 | 2006-07-29 |
| 1568489417 | Nosratollah Ghaemmaghami | Internal Medicine | 381 Medical Drive, Jackson, MS 39216 | 2006-07-16 |
| 1629007406 | Kent Alan Kirchner | Internal Medicine | 1500 E. Woodrow Wilson Blvd, Jackson, MS 39216-5199 | 2006-07-02 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1457844599 | Kidney & Hypertension Specialists of Jackson Piketon and Chillicothe L | Internal Medicine | 3 Acy Ave, Jackson, OH 45640-9561 | 2018-06-13 |
| 1104331511 | Aldo Torres | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2017-12-07 |
| 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.