DR. TRACEY F PETRIDES (NPI# 1295927226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295927226 |
| Entity Type | Individual |
| Full Name | DR. TRACEY F PETRIDES |
| Credential | M.D. |
| Practice Address |
5779 Getwell Road Building D, Suite 3 Southaven MS 38672 |
| Practice Telephone | 6625106507 |
| Practice Fax Number | 6625106508 |
| Mailing Telephone | 6625106507 |
| Mailing Fax Number | 6625106508 |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2012-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 17839 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
5779 GETWELL ROAD BUILDING D, SUITE 3 |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
| 1356713606 | Deadra Dennis | Behavioral Analyst | 2816 Calico Rock Cv, Southaven, MS 38672 | 2015-10-27 |
| 1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
| 1659516524 | Stacy L Sanders | Audiologist | 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 | 2008-12-08 |
| 1538288741 | Bruce A Denney | Dentist | 7125 Getwell Road, Suite 102, Southaven, MS 38672 | 2007-03-28 |
| 1154480150 | Kimberly Marie Metcalf | Social Worker | 7165-g Getwell Rd., Southaven, MS 38672 | 2006-12-06 |
| 1346318441 | Deborah Verucchi | Nurse Practitioner | 5740 Getwell Rd Ste B, Southaven, MS 38672 | 2006-11-30 |
| 1063520294 | Michael Newton Phillips | Physical Therapist | 3451 Goodman Rd E Ste 108, Southaven, MS 38672 | 2006-08-28 |
| Find all providers in zip 38672 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891352514 | Linda A Foster Md PC | Family Medicine | 7900 Airways Blvd Bldg C1, Southaven, MS 38671-4114 | 2019-05-29 |
| 1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
| 1518270636 | Madiha Dar Haji | Family Medicine | 7736 Airways Boulevard, Southaven, MS 38671 | 2010-07-18 |
| 1982936126 | Sunil Malhotra | Family Medicine | 470 Goodman Rd E, Southaven, MS 38671-9557 | 2010-02-12 |
| 1700088085 | Kallol Kumar Saha | Family Medicine | 340 Stateline Rd W, Southaven, MS 38671-1610 | 2007-05-31 |
| 1013039288 | Carnahan Clinic Pllc | Family Medicine | 7900 Airways Blvd Bldg A Ste 6, Southaven, MS 38671-4113 | 2007-04-06 |
| 1083776116 | Edward Arnold Steward | Family Medicine | 1669 Main St Ste A, Southaven, MS 38671-1223 | 2006-12-14 |
| 1093887945 | Gary Dwain Carr | Family Medicine | 5699 Getwell Rd Ste 1, Southaven, MS 38672-7312 | 2006-11-15 |
| 1588743314 | Patrick Andrew Ball | Family Medicine | 7736 Airways Blvd., Southaven, MS 38671-5306 | 2006-11-03 |
| 1528150398 | Desoto Family Medical Center | Family Medicine | 75 Physician Lane, Southaven, MS 38671 | 2006-09-29 |
| Find all providers in SOUTHAVEN | ||||
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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.