PHOEBE GORDON (NPI# 1255579330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255579330 |
| Entity Type | Individual |
| Full Name | PHOEBE GORDON |
| Credential | MT |
| Practice Address |
109 Pine Knoll Dr Apt 324 Ridgeland MS 39157-1350 |
| Practice Telephone | 6019400043 |
| Mailing Telephone | 6019400043 |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2009-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QB0000X |
Spec/Tech, Pathology Specialization: Blood Banking |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
109 PINE KNOLL DR APT 324 |
| City | RIDGELAND |
| State | MS |
| Zip Code | 39157-1350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760683635 | Andrew Clark | Student in an Organized Health Care Education/Training Program | 109 Pine Knoll Dr, 347, Ridgeland, MS 39157-1350 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1225680945 | Verthena Edwards | Home Health | 301 Pinehurst Cir, N/a, Ridgeland, MS 39157 | 2019-07-12 |
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1841786365 | Whitney Paige Crum | Speech-Language Pathologist | Laskin Therapy Group Pa, 207 W Jackson St, Ridgeland, MS 39157 | 2018-07-09 |
| 1811487002 | Camille Brockett | Social Worker | 270 Trace Colony Park Dr Ste B, Ridgeland, MS 39157 | 2018-05-14 |
| 1588171177 | Layson Counseling Group, Pllc | Counselor | 573 Hwy 51 Suite B, Ridgeland, MS 39157 | 2018-01-04 |
| 1407376452 | Mobility Rehab LLC | Clinic/Center | 745 S Pear Orchard Road, Apt 335, Ridgeland, MS 39157 | 2017-06-21 |
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1851755714 | Jerlunda Lynn Dudley | Social Worker | 511 Clark Street, Rosedale, MS 39157 | 2016-04-07 |
| Find all providers in zip 39157 | ||||
| Taxonomy Code | 246QB0000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Blood Banking |
| Definition to come... |
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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.