MATTHEW WYNNE (NPI# 1306263678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306263678 |
| Entity Type | Individual |
| Full Name | MATTHEW WYNNE |
| Credential | MD |
| Practice Address |
620 Skyline Dr Jackson TN 38301-3923 |
| Practice Telephone | (731) 541-5000 |
| Practice Fax Number | 7314100367 |
| Mailing Telephone | (731) 541-5000 |
| Mailing Fax Number | 7314100367 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD0000053625 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 294 Summar Dr, Jackson, TN 383013915 | 7314231932 | 7314100367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822463 | Matthew Thomas Wynne | Counselor | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-18 |
| 1356985949 | Matthew Christopher Wynne | Student in an Organized Health Care Education/Training Program | 2151 Old Brick Rd, Glen Allen, VA 23060-5837 | 2019-11-06 |
| Street Address |
620 SKYLINE DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094608 | Julie A Mcbroom | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2005-06-25 |
| 1205440260 | Heather Middleton | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-09-06 |
| 1780297291 | Holly R Jones | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-08-25 |
| 1851909972 | Earl Wade Lomax | Student in an Organized Health Care Education/Training Program | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-07-15 |
| 1356960835 | Gregory Heath Mcneely | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-04-14 |
| 1174157515 | Matthew Lee Luttrell | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-02-25 |
| 1528698594 | Heidi Hill | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-01-18 |
| 1407406861 | Justin Harrison | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-09-18 |
| 1770131856 | Shelby Kathryn Berry | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-30 |
| 1891342028 | Jack Harold Fields IIi | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| 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 |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1003470758 | Central Mississippi Health Services, Inc | Family Medicine | 3450 Highway 80 W Ste 71, Jackson, MS 39209-7201 | 2019-04-29 |
| 1922515493 | Meaghan Schenk Johnson | Family Medicine | 2969 Curran Dr N # 200, Jackson, MS 39216-4121 | 2018-01-05 |
| 1740795731 | Emily Colleen Dunaway | Family Medicine | 1227 N State St # 101, Jackson, MS 39202-2002 | 2017-12-12 |
| 1679086367 | Hope Np House Call Practice | Family Medicine | 98 Grandview Ave, Jackson, OH 45640-9090 | 2017-11-16 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1891235289 | Logan Hardin | Family Medicine | 1270 Union University Dr Ste A, Jackson, TN 38305-3856 | 2017-03-03 |
| 1255782843 | Seth Tyler Koehler | Family Medicine | 2600 E Main St, Jackson, MO 63755-2473 | 2016-06-25 |
| 1720495245 | Gopi Patel | Family Medicine | 27 S Cooks Bridge Rd Ste 2-1, Jackson, NJ 08527-2524 | 2014-07-16 |
| 1154735165 | Lk Physicians Services Pllc | Family Medicine | 36 Lake Pointe Dr, Jackson, TN 38305-8113 | 2014-06-17 |
| 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.