MR. JESSE IVY GARRETT III (NPI# 1336232529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336232529 |
| Entity Type | Individual |
| Full Name | MR. JESSE IVY GARRETT III |
| Practice Address |
1500 East Woodrow Wilson Drive Jackson MS 39216-9765 |
| Mailing Address |
114 Cedar Crest Drive Clinton MS 39056-9765 |
| Practice Telephone | 6013641555 |
| Mailing Telephone | 6019241500 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E6146 | MS | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RPH LICENSE NUMBER | E6146 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821548819 | Jesse Garrett | Acupuncturist | 1418 Grand Ave, Saint Paul, MN 55105-2205 | 2016-10-13 |
| 1881064327 | Jesse Garrett | Pharmacist | 1115 N Riverside Dr, Espanola, NM 87532-2802 | 2015-09-27 |
| Street Address |
1500 EAST WOODROW WILSON DRIVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-9765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336173905 | Randy Scott Burke | Psychologist | 1500 East Woodrow Wilson Drive, Addictive Disorders Treatment Program (116a4), Vamc, Jackson, MS 39216 | 2006-07-10 |
| 1467607416 | Choon-man Joseph Kim | Nuclear Medicine | 1500 East Woodrow Wilson Drive, Radiology Service, G.v. Montgomery Va Medical Center, Jackson, MS 39216 | 2008-11-18 |
| 1548422967 | Sommer L Rodrigue | Speech-Language Pathologist | 1500 East Woodrow Wilson Drive, Gv Sonny Montgomery Department of Veterans Affairs, Jackson, MS 39216-5199 | 2008-06-26 |
| 1851452080 | Alvin Wayne Rembert | Dentist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-12-12 |
| 1134218076 | Andre' Badelle Robinson | Occupational Therapist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-10-11 |
| 1730274887 | Department of Veterans Affairs | Dietitian, Registered | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-10-04 |
| 1639263924 | Liep H Tjeng | Rehabilitation Practitioner | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-10-03 |
| 1306930680 | Cecilia D Fowler | Occupational Therapist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-10-03 |
| 1871694240 | Julie Larae Robbins | Nursing Facility/Intermediate Care Facility | 1500 East Woodrow Wilson Drive, Jackson, MS 39206 | 2006-09-26 |
| 1396843694 | Ruby Ellis Denson | Nurse Practitioner | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| 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 |
| 1790398287 | Haleema Saadia | Pharmacist | 3144 North Avenue, Jackson, TN 38305-0100 | 2020-08-25 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1124645965 | Archis B Patel | Pharmacist | 6 Moet Ct, Jackson, NJ 08527-3090 | 2020-06-27 |
| 1417579798 | Alvin Ray Stewart Sr. | Pharmacist | 696 Cedar Springs Dr, Jackson, MS 39212-5710 | 2020-05-10 |
| 1033731492 | Jamie Hines Mckinley | Pharmacist | 1500 E Woodrow Wilson Ave Dept 119-a, Jackson, MS 39216-5116 | 2020-05-08 |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1770130650 | Elizabeth Hearn | Pharmacist | 1345 Simwood Pl, Jackson, MS 39211-6352 | 2019-08-24 |
| 1306493929 | Stephen Benjamin Porter | Pharmacist | 350 W Woodrow Wilson Ave Rm Me101-42, Jackson, MS 39213-7681 | 2019-08-19 |
| 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.