JONATHAN PRINCIOTTA (NPI# 1215476064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215476064 |
| Entity Type | Individual |
| Full Name | JONATHAN PRINCIOTTA |
| Practice Address |
2500 N State St 2500 North State Street Jackson MS 39216-4500 |
| Mailing Address |
510 Pinebark Cv Brandon MS 39047-4447 |
| Practice Telephone | 6018156960 |
| Mailing Telephone | 2282389187 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
901958 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05103351 | 05 |
| Street Address |
2500 N STATE ST 2500 NORTH STATE STREET |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| 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 | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861911372 | Brennan Williams | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2017-09-15 |
| 1811360993 | Alex Barraza Taylor | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2015-11-11 |
| 1659787307 | Frances Hampton Tynes | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2014-07-02 |
| 1093157414 | Amy Lowery Carroll | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2013-07-26 |
| 1265796981 | Alicon Kathleen Johnson | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2012-06-27 |
| 1144527292 | Shanda Sandridge | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2011-02-24 |
| 1497052211 | Jennifer Eden Mcdaniel | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2011-02-14 |
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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.