RESTORATIV (NPI# 1134778988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134778988 |
| Entity Type | Organization |
| Organization Name | RESTORATIV |
| Practice Address |
129 Fountains Blvd Ste 101 Madison MS 39110-6361 |
| Practice Telephone | 7693000730 |
| Practice Fax Number | 6019492782 |
| Mailing Telephone | 7693000730 |
| Mailing Fax Number | 6019492782 |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |
| Authorized Official Name | ANGEL VANCE (DIRECTOR) |
| Authorized Official Telephone | 7693000730 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | RESTORATIVE ACTION ALLIANCE, INC. | 282 Katonah Avenue, Katonah, New York 10536 |
| Oregon Corporations, Companies and Business Names | RESTORATIVE ACTION ALLIANCE, LLC | 3037 Se Caruthers Street, Portland, OR 97214 |
| New York State Corporations | RESTORATIVE ACTION FOUNDATION, INC. | 282 Katonah Avenue, Katonah, Ny 10536 |
| Colorado Business Entities | Restorative Adventures LLC | 138 Woodchuck Ct, Silverthorne, CO 80498 |
| Alabama Business Registrations | Restorative Advocacy, LLC | 4316 Chickasaw Dr Se, Huntsville, AL 35801 |
| Colorado Business Entities | RESTORATIVE AND AESTHETIC DENTISTRY, P.C. | 5040 Stonehill Rd, Colorado Springs, CO 80918 |
| Colorado Business Entities | Restorative and Equitable Justice Project | 8585 Criterion Drive, # 62519 - Simaner, Colorado Springs, CO 80962 |
| Washington State Corporations | RESTORATIVE BALANCE | 522 W Riverside Ave Ste N, Spokane, WA 99201-0580 |
| Oregon Corporations, Companies and Business Names | RESTORATIVE BLENDS LLC | 505 Sw Mill View Way Ste 200, Bend, OR 97702 |
| Oregon Corporations, Companies and Business Names | RESTORATIVE BODY, LLC | 3873 Ulu Alii St, Kalaheo, HI 96741 |
| Street Address |
129 FOUNTAINS BLVD STE 101 |
| City | MADISON |
| State | MS |
| Zip Code | 39110-6361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326451741 | Micah R. Walker | Family Medicine | 129 Fountains Blvd Ste 101, Madison, MS 39110-6344 | 2014-06-03 |
| 1427562156 | Melissa B Jackson | Nurse Practitioner | 129 Fountains Blvd Ste 101, Madison, MS 39110-6344 | 2017-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356737464 | Michael Gibson | Anesthesiology | 700 S Park St, Madison, WI 53715-1830 | 2015-04-15 |
| 1124275565 | Comprehensive Pain Center of Mississippi | Anesthesiology | 129 Fountains Blvd, Madison, MS 39110 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588158125 | Gulf Coast Anesthesia Associates | Anesthesiology | 147 Reynoir St Ste 305, Biloxi, MS 39530 | 2018-06-18 |
| 1063878676 | Wayne General Hospital | Anesthesiology | 940 Matthew Dr Ste 8, Waynesboro, MS 39367-2534 | 2016-01-12 |
| 1700137205 | Gulf Coast Interventional Pain Management Clinic, Inc. | Anesthesiology | 15164 Dedeaux Rd Ste B, Gulfport, MS 39503-3124 | 2012-09-24 |
| 1982996567 | Mb Costello Enterprises LLC | Anesthesiology | 1501 Lakeland Dr Ste 251, Jackson, MS 39216-4848 | 2011-05-13 |
| 1699081745 | Anesthesia & Pain Control Services, Inc. | Anesthesiology | 180b Debuys Rd Ste 211, Biloxi, MS 39531-4407 | 2010-08-27 |
| 1134214331 | Coastal Chronic Pain Services, Pllc | Anesthesiology | 15190 Community Rd Ste 230b, Gulfport, MS 39503-3483 | 2006-10-04 |
| 1295845311 | Bretley Todd Sitzman | Anesthesiology | 7125 U S Highway 98, Hattiesburg, MS 39402 | 2006-08-30 |
| 1285663633 | Joe Christopher Cook I | Anesthesiology | 114 Byram Business Center Dr, Byram, MS 39272-9636 | 2006-06-30 |
| 1821034596 | Rex B Williams | Anesthesiology | 120 Stone Creek Blvd, Suite 500, Flowood, MS 39232-8205 | 2006-06-21 |
| 1598703852 | Miguel Figueroa | Anesthesiology | 46 Sgt Prentiss Dr Ste 201, Natchez, MS 39120-4751 | 2006-06-02 |
| 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.