CLEMENTINE YALONDA SULLIVAN (NPI# 1134584998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134584998 |
| Entity Type | Individual |
| Full Name | CLEMENTINE YALONDA SULLIVAN |
| Practice Address |
151 E Metro Dr Ste 203 Flowood MS 39232-4405 |
| Practice Telephone | 6013828337 |
| Mailing Telephone | (601) 382-8337 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2017-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 1928 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
151 E METRO DR STE 203 |
| City | FLOWOOD |
| State | MS |
| Zip Code | 39232-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164071775 | Leanna Nicole Howard | Social Worker | 2945 Layfair Drive, Apt. 1621, Flowood, MS 39232 | 2019-09-06 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1285101816 | Magnolia Anesthesia Consultants LLC | Anesthesiology | 4209 Lakeland Dr #252, Flowood, MS 39232 | 2018-11-01 |
| 1528543592 | Matthew T Armstrong | Physical Therapist | 104 Burney Drive, Flowood, MS 39232 | 2018-09-26 |
| 1790265627 | Mississippi Brain and Spine, Pllc | Non-Pharmacy Dispensing Site | 1 Layfair Drive, Ste 120, Flowood, MS 39232 | 2018-08-20 |
| 1629574918 | Billy Clifton Osbon Jr. | Pharmacist | 2506 Lakeland Drive, Suite 201, Flowood, MS 39232 | 2018-04-04 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1508398983 | Charles Pearson | Student in an Organized Health Care Education/Training Program | 764 Flowood Dr, Flowood, MS 39232 | 2017-04-03 |
| 1396288197 | Mary Claire Ponder | Nurse Practitioner | 151 E Metro Dr Ste 103, Flowood, MS 39232 | 2016-11-28 |
| Find all providers in zip 39232 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477000347 | Lacey Green Clark | Massage Therapist | 5419 Highway 25 Ste R, Flowood, MS 39232-6343 | 2016-09-07 |
| 1164979084 | The Wellness Spa, LLC | Massage Therapist | 5419 Highway 25 Ste R, Flowood, MS 39232-6343 | 2016-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033728639 | Latoya R Thompson | Massage Therapist | 119 S Madison St, Kosciusko, MS 39090-3628 | 2020-07-29 |
| 1477174928 | Tina Whitehead | Massage Therapist | 518 Hwy 12 W, Starkville, MS 39759 | 2020-05-06 |
| 1275154338 | Crystal Edwards | Massage Therapist | 2718 Medgar Evers Blvd, Jackson, MS 39213-7257 | 2020-04-30 |
| 1265063135 | Georgene Ferrie | Massage Therapist | 1612 Main St., Fayette, MS 39069 | 2020-01-30 |
| 1578103735 | Sandra Suggs | Massage Therapist | 2621 W Oxford Loop Ste C, Oxford, MS 38655-5442 | 2020-01-15 |
| 1881236479 | Donna Summers | Massage Therapist | 761 Woodlake Dr, Jackson, MS 39206-2219 | 2019-10-15 |
| 1538715305 | Charles Louis Wilson | Massage Therapist | 2900 Government St Ste A, Ocean Springs, MS 39564-5647 | 2019-08-16 |
| 1619531084 | Derek Cumberland | Massage Therapist | 505 Oakleigh Pl, Brandon, MS 39047-6297 | 2019-04-30 |
| 1710461223 | Lamonica P Starks | Massage Therapist | 118 Weisenberger Rd Ste 200, Madison, MS 39110-5012 | 2018-09-20 |
| 1497295117 | Eletha Walker | Massage Therapist | 215 Walker Smith Rd, Florence, MS 39073 | 2017-02-28 |
| 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.