MR. SAMUEL E. FLEMING III (NPI# 1285614370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285614370 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL E. FLEMING III |
| Credential | PH.D. |
| Practice Address |
211 N Madison St Tupelo MS 38804-3807 |
| Practice Telephone | 6628449003 |
| Practice Fax Number | 6628449304 |
| Mailing Telephone | 6628449003 |
| Mailing Fax Number | 6628449304 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 661 | AL | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | 46805 | MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01854707 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518598606 | Samuel Fleming | Student in an Organized Health Care Education/Training Program | 5603a Joe Sayers Ave, Austin, TX 78756-1311 | 2020-01-28 |
| 1861912172 | Samuel Dixon Fleming | Emergency Medicine | 316 Calhoun St, Charleston, SC 29401-1113 | 2017-06-27 |
| 1770587743 | Samuel Bryson Fleming II | Internal Medicine | 10 Mcdowell St, Asheville, NC 28801-4104 | 2005-06-08 |
| 1972506996 | Samuel S Fleming | Orthopaedic Surgery | 300 Tower Rd Ne, Ste 200, Marietta, GA 30060-9403 | 2005-05-23 |
| Street Address |
211 N MADISON ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083890784 | Mary French | Counselor | 211 N Madison St, Tupelo, MS 38804 | 2008-01-14 |
| 1043398928 | Sandra M Bruff | Counselor | 211 N Madison St, Tupelo, MS 38804-3807 | 2006-11-01 |
| 1306939384 | Margaret Koranek | Psychologist | 211 N Madison St, Tupelo, MS 38804-3807 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720022973 | William Brian Thomas | Clinical Neuropsychologist | 144 S Thomas St Ste 104a, Tupelo, MS 38801-5337 | 2006-06-16 |
| 1972924033 | Brian Thomas, Psy.d. Pllc | Clinical Neuropsychologist | 144 S Thomas St, Ste 103 Room 1, Tupelo, MS 38801-5312 | 2013-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073093894 | Virginia Catherine Persinger | Clinical Neuropsychologist | 1350 E Woodrow Ave, Jackson, MS 39216-5112 | 2018-08-21 |
| 1780963793 | Joy Humphreys Clark | Clinical Neuropsychologist | 1350 E. Woodrow Wilson, Jackson, MS 39216-5112 | 2011-08-08 |
| 1194028555 | Gulf Coast Neuropsychology, LLC | Clinical Neuropsychologist | 16195c Landon Rd, Gulfport, MS 39503-4121 | 2010-12-07 |
| 1871818369 | Brian Heath Gordon | Clinical Neuropsychologist | 357 Towne Center Blvd Ste 403, Ridgeland, MS 39157-4844 | 2010-03-29 |
| 1699968453 | Ethel Wiest Hetrick | Clinical Neuropsychologist | 412 Highway 90, Suite 10, Bay Saint Louis, MS 39520-3534 | 2007-08-23 |
| 1922210103 | Kevin J. Mccarthy | Clinical Neuropsychologist | 415 W Canal St, Picayune, MS 39466-3912 | 2007-05-03 |
| 1518049238 | Andrea Lyn Todd | Clinical Neuropsychologist | 542 Arbor Station Dr, Long Beach, MS 39560-5741 | 2006-10-20 |
| 1124527841 | Clinical & Forensic Neuropsychology Services LLC | Clinical Neuropsychologist | 357 Towne Center Blvd Ste 403, Ridgeland, MS 39157-4844 | 2018-02-08 |
| 1023402047 | Nancy H. Goldman, LLC | Clinical Neuropsychologist | 3000 Old Canton Rd, Suite 465, Jackson, MS 39216-4200 | 2015-03-27 |
| 1952727430 | Racha Fares | Clinical Neuropsychologist | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2014-03-08 |
| 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.