MERCY CLINIC OF JACKSON, PLLC (NPI# 1306047105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306047105 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC OF JACKSON, PLLC |
| Practice Address |
1550 Highway 15 S Suite 80 Jackson KY 41339-7247 |
| Practice Telephone | 6066930343 |
| Practice Fax Number | 6066930322 |
| Mailing Telephone | 6066930343 |
| Mailing Fax Number | 6066930322 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-10-04 |
| Authorized Official Name | SUSAN PRATT (CLINIC MANAGER) |
| Authorized Official Telephone | 6066930343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 31497 | KY | Other Service Providers |
| Street Address |
1550 HIGHWAY 15 S SUITE 80 |
| City | JACKSON |
| State | KY |
| Zip Code | 41339-7247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285635698 | Cesar Ocampo Agtarap | Internal Medicine | 1550 Highway 15 S, Suite 80, Jackson, KY 41339-7247 | 2005-08-09 |
| 1508102427 | Jessica N Oldfield | Counselor | 1550 Highway 15 S, Suite 200, Jackson, KY 41339-7247 | 2012-12-20 |
| 1508199852 | Dr Steven Howard Pllc Chiropractor | Chiropractor | 1550 Highway 15 S, Suite 24, Jackson, KY 41339-7247 | 2009-09-17 |
| 1619984960 | Steven Ray Howard | Chiropractor | 1550 Highway 15 S, Suite 24, Jackson, KY 41339-7247 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
| 1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
| 1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
| 1023641446 | Andreanna Gibbs | Physical Therapy Assistant | 100 Hwy 15, Jackson, KY 41339 | 2020-02-13 |
| 1144797754 | Visionary Rehabilitation Services, LLC | Speech-Language Pathologist | 100 Kentucky Hwy 15 South, Suite 136, Jackson, KY 41339 | 2018-11-01 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| 1508225996 | Jessica Williams | Pharmacist | 842 Highway 15 N, Jackson, KY 41339 | 2016-02-15 |
| 1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
| 1265784045 | Jonathan Charles Morris | Physical Therapist | 695 Ky Hwy 15 N, Ste 3, Jackson, KY 41339 | 2012-10-04 |
| 1649539958 | Henry Price Sewell IIi IIi | Family Medicine | 170 Picnic Hill Rd, Jackson, KY 41339 | 2012-05-07 |
| Find all providers in zip 41339 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1396271565 | Karlisha Britton | Specialist | 7 Lakeland Circle, Suite 300, Jackson, MS 39216 | 2017-05-10 |
| 1922545896 | Paul Edward Ruttle | Specialist | 2640 Trader Rd, Jackson, WY 83001-8321 | 2017-01-30 |
| 1780121483 | Andrew Callis | Specialist | 5303 Old Cape Rd E, Jackson, MO 63755-3850 | 2017-01-19 |
| 1538617055 | Jonathan Parker | Specialist | 95 Riverport Dr, Jackson, TN 38301-5748 | 2016-09-13 |
| 1386096600 | Miriam Bick | Specialist | 4 Florida Pl, Jackson, NJ 08527-1816 | 2016-07-11 |
| 1326429572 | Alonzo Roberts | Specialist | 6110 Highway 18 W, Jackson, MS 39209-9322 | 2015-06-13 |
| 1407289275 | Andrew Francis Charland | Specialist | N168w22224 Main St Ste E, Jackson, WI 53037-9321 | 2013-08-15 |
| 1265872501 | Robyn Abbott Roberts | Specialist | 1904 Lakeland Dr, Suite D, Jackson, MS 39216-5038 | 2013-07-01 |
| 1053754580 | Massage Revolution | Specialist | 210 E Capitol St, Ste M-142, Jackson, MS 39201-2306 | 2013-04-15 |
| Find all providers in JACKSON | ||||
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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.