EXECUTIVE DIAGNOSTICS LLC (NPI# 1134699945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134699945 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE DIAGNOSTICS LLC |
| Practice Address |
5455 Executive Pl Ste B Jackson MS 39206-4104 |
| Mailing Address |
10996 Four Seasons Pl Ste 100a Crown Point IN 46307-8685 |
| Practice Telephone | 2193950667 |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | DR. KIRNJOT SINGH (PRESIDENT) |
| Authorized Official Telephone | 2193950667 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
5455 EXECUTIVE PL STE B |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-4104 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922616168 | Quest Diagnostics | Clinical Medical Laboratory | 14590 State Route 93 Ste A, Jackson, OH 45640-8977 | 2020-07-14 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1174028856 | W. A. Foote Memorial Hospital, Inc. | Clinical Medical Laboratory | 1100 E Michigan Ave Ste 104, Jackson, MI 49201-1800 | 2018-03-26 |
| 1649775495 | W. A. Foote Memorial Hospital, Inc. | Clinical Medical Laboratory | 1201 E Michigan Ave Ste 115, Jackson, MI 49201-1852 | 2018-03-26 |
| 1881064772 | Apple Pharmaceuticals & Healthcare Services, LLC | Clinical Medical Laboratory | 115 Riley Dr, Jackson, MS 39209-2595 | 2015-10-05 |
| 1508069824 | Transsouth Health Care PC | Clinical Medical Laboratory | 14 Weatherford Sq, Jackson, TN 38305 | 2007-06-06 |
| 1316084015 | Medical Genetics Lab | Clinical Medical Laboratory | 2500 N State St Dept Cgen, Room R622, Jackson, MS 39216-4500 | 2007-01-31 |
| 1356374912 | Dermatopathology Associates, Pllc | Clinical Medical Laboratory | 3120 Old Canton Rd, Jackson, MS 39216 | 2006-07-08 |
| 1760469076 | Garcia Clinical Laboratory Inc | Clinical Medical Laboratory | 2195 Spring Arbor Rd, Jackson, MI 49203-2797 | 2005-12-28 |
| 1457336067 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1031 N Flowood Dr, Jackson, MS 39232-9533 | 2005-12-07 |
| 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.