GRENADA LAKE INPATIENT MEDICINE ASSOCIATES (NPI# 1235284928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235284928 |
| Entity Type | Organization |
| Organization Name | GRENADA LAKE INPATIENT MEDICINE ASSOCIATES |
| Practice Address |
960 J K Avent Dr Grenada MS 38901-5230 |
| Mailing Address |
Po Box 52007 Atlanta GA 30355-0007 |
| Practice Telephone | 6622277492 |
| Practice Fax Number | 6622277541 |
| Mailing Telephone | 6783970060 |
| Mailing Fax Number | 6783970065 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | KEITH HEARTSILL (CFO) |
| Authorized Official Telephone | 6622277172 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
960 J K AVENT DR |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-5230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922187095 | Grenada Lake Medical Center | Orthopaedic Surgery | 960 J K Avent Dr, Grenada, MS 38901-5230 | 2006-11-02 |
| 1780015396 | State of Mississippi-university of Mississippi Medical Center | Ambulance | 960 J K Avent Dr, Grenada, MS 38901-5230 | 2013-12-06 |
| 1255496881 | Lewis Wesley Keen Jr. | Registered Nurse | 960 J K Avent Dr, Grenada, MS 38901-5230 | 2006-12-26 |
| 1790849354 | Grenada Lake Medical Center | General Acute Care Hospital | 960 J K Avent Dr, Grenada, MS 38901 | 2006-12-20 |
| 1326109505 | Grenada Lake Medical Center | General Acute Care Hospital | 960 J K Avent Dr, Grenada, MS 38901 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437711991 | Amanda L Wiltshire | Internal Medicine | 1300 Sunset Dr Ste A, Grenada, MS 38901-4081 | 2019-07-05 |
| 1215224563 | Cedric Edwards | Internal Medicine | 2340 Sunset Dr Ste C, Grenada, MS 38901-2827 | 2011-07-07 |
| 1023129608 | Joseph Frank Roberts | Internal Medicine | 1117 Sunset Dr, Suite 101, Grenada, MS 38901-4080 | 2006-08-31 |
| 1750336574 | Mississippi Inpatient Medicine Associates, Pllc | Internal Medicine | 965 Avent Dr, Grenada, MS 38901-5045 | 2006-05-23 |
| 1265792360 | Jarriet Anne Hinunangan Ting | Internal Medicine | 960 Avent Dr, Grenada, MS 38901-5230 | 2012-05-22 |
| 1629269709 | Joseph F Roberts Md Pa | Internal Medicine | 1117 Sunset Dr, Suite 101, Grenada, MS 38901-4080 | 2007-08-05 |
| 1518980887 | Joseph S Messina Jr. | Internal Medicine | 1300 Sunset Drive, Suite A, Grenada, MS 38901 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275148264 | Ludmila Nahar | Internal Medicine | 18 Windwood Cv, Flowood, MS 39232-7921 | 2020-09-15 |
| 1013533637 | Ochsner Mississippi, LLC | Internal Medicine | 111 N Cleveland Ave, Long Beach, MS 39560-4713 | 2020-06-19 |
| 1215556048 | Hannah Roberts Badon | Internal Medicine | 2450 Wild Valley Dr, Jackson, MS 39211-6224 | 2020-04-12 |
| 1649809476 | Rachel Horn Mullins | Internal Medicine | 5379 Fairway St, Jackson, MS 39211-4251 | 2020-04-03 |
| 1497391288 | Ahmad Abdali Haidar Md Pa | Internal Medicine | 200 Golf Course Dr, Carriere, MS 39426-9037 | 2019-11-27 |
| 1447812540 | Waqaar Ahmed Arshad | Internal Medicine | 3226 Kendrick Rd Apt 14, Corinth, MS 38834-9207 | 2019-06-28 |
| 1023675048 | Fitvisits LLC | Internal Medicine | 731 S Pear Orchard Rd Ste 16, Ridgeland, MS 39157-4800 | 2019-05-24 |
| 1629542832 | Internal Medicine Primary Care Pa | Internal Medicine | 140 Daughdrill Sta, Flowood, MS 39232-8406 | 2019-01-22 |
| 1003313180 | Ochsner Mississippi, LLC | Internal Medicine | 4550 Shepherd Sq, Diamondhead, MS 39525-3325 | 2018-04-06 |
| 1619477577 | Ochsner Mississippi, LLC | Internal Medicine | 202 Drinkwater Rd, Bay St Louis, MS 39520-1638 | 2018-02-17 |
| 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.