MADISON HEALTHPLEX AND SPORTS PERFORMANCE CENTER LLC (NPI# 1184174914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184174914 |
| Entity Type | Organization |
| Organization Name | MADISON HEALTHPLEX AND SPORTS PERFORMANCE CENTER LLC |
| Other Organization Name | MADISON HEALTHPLEX PERFORMANCE TRAINING CENTER |
| Practice Address |
501 Baptist Dr Madison MS 39110-2030 |
| Practice Telephone | 6018567757 |
| Practice Fax Number | 6019449780 |
| Mailing Telephone | 6018567757 |
| Mailing Fax Number | 6019449780 |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |
| Authorized Official Name | GREG CENTILLI (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6018567757 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| Madison Healthplex Performance Training Center | Doing Business As Name - Organization |
| Street Address |
501 BAPTIST DR |
| City | MADISON |
| State | MS |
| Zip Code | 39110-2030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588692636 | William Clay Ashford | Ophthalmology | 501 Baptist Dr, Suite 220, Madison, MS 39110-2030 | 2006-06-29 |
| 1033698451 | Daniel Hartman | Physical Therapist | 501 Baptist Dr, Madison, MS 39110-2030 | 2018-08-07 |
| 1467861484 | Julie Brewer Dawson | Optometrist | 501 Baptist Dr, Suite160, Madison, MS 39110-2026 | 2014-08-04 |
| 1073938635 | Image Optical LLC | Ophthalmology | 501 Baptist Dr, Suite 140, Madison, MS 39110-2026 | 2014-02-19 |
| 1891117420 | Madison Healthplex & Sports Performance Center LLC | Physical Therapist | 501 Baptist Dr, Madison, MS 39110-2026 | 2014-01-16 |
| 1023202074 | William C Ashford M.d. | Ophthalmology | 501 Baptist Dr, Suite 220, Madison, MS 39110-2030 | 2007-09-04 |
| 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 | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659900405 | Jessica Dean Nutrition, LLC | Dietitian, Registered | 111 Bradley Rd, Madison, CT 06443-2601 | 2020-04-03 |
| 1851950893 | Heather Marie Nereson Lorden | Dietitian, Registered | 600 Highland Aveneu, Madison, WI 53792-0001 | 2019-06-12 |
| 1891255543 | Vincent Gene Suha | Dietitian, Registered | 214 Rosemary Ave, Madison, WI 53714-1842 | 2019-03-20 |
| 1174024392 | Everyday Nutrition | Dietitian, Registered | 547 Florence Dr, Madison, MS 39110-7326 | 2018-02-22 |
| 1740789502 | Kimberly Kaye Swanson | Dietitian, Registered | 34 Schroeder Ct Ste 230, Madison, WI 53711-2528 | 2018-02-07 |
| 1134658537 | Diane Bierbauer | Dietitian, Registered | 520 Thoreau Spring Ct, Madison, AL 35758 | 2017-06-08 |
| 1316487614 | Emily Bawden | Dietitian, Registered | 110 N Livingston St Apt 481, Madison, WI 53703-4431 | 2017-03-06 |
| 1083151526 | Nutrition, LLC | Dietitian, Registered | 347 Waters Edge Ln, Madison, AL 35758-2561 | 2017-01-23 |
| 1033655048 | Sarah Dreifke | Dietitian, Registered | 600 Highland Ave # 1510, Madison, WI 53792-0001 | 2017-01-13 |
| 1831641646 | Rachel Roser | Dietitian, Registered | 10 Loomis Cir, Apt 2, Madison, WI 53704-8931 | 2016-10-27 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on MADISON HEALTHPLEX AND SPORTS PERFORMANCE CENTER LLC.
| 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.