MEDICAL FOUNDATION, INC. (NPI# 1346654027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346654027 |
| Entity Type | Organization |
| Organization Name | MEDICAL FOUNDATION, INC. |
| Other Organization Name | RUSH MEDICAL GROUP PROFESSIONAL BUILDING |
| Practice Address |
1800 12th St Meridian MS 39301-4158 |
| Mailing Address |
Po Box 5183 Meridian MS 39302-5183 |
| Practice Telephone | 6014846700 |
| Practice Fax Number | 6017039162 |
| Mailing Telephone | 6017034282 |
| Mailing Fax Number | 6017033080 |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2018-02-26 |
| Authorized Official Name | DON LARKIN KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 6017039614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Rush Medical Group Professional Building | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194191684 | Medical Foundation, Inc. | Family Medicine | 5100 Hwy 21 South, Preston, MS 39354 | 2015-08-19 |
| 1275930174 | Medical Foundation, Inc. | Anesthesiology | 1200 16th Ave, Meridian, MS 39301-4209 | 2014-11-21 |
| 1467857102 | Medical Foundation, Inc. | Clinical Medical Laboratory | 1306 20th Avenue, Meridian, MS 39301 | 2014-10-23 |
| 1891353462 | Medical Foundation, Inc. | Obstetrics & Gynecology | 2303 13th St, Meridian, MS 39301-3940 | 2019-05-30 |
| 1386118602 | Medical Foundation, Inc. | Pediatrics | 252 Northside Dr, Newton, MS 39345-9756 | 2019-01-21 |
| 1235598624 | Medical Foundation, Inc. | Obstetrics & Gynecology | 2401 16th St, Meridian, MS 39301-3950 | 2016-02-15 |
| 1770985020 | Medical Foundation, Inc. | Obstetrics & Gynecology | 1056 Holland Ave, Suite A, Philadelphia, MS 39350-9121 | 2014-09-18 |
| 1144633363 | Medical Foundation, Inc. | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-06-05 |
| 1811300395 | Medical Foundation, Inc. | Psychiatry & Neurology | 1800 12th St, Meridian, MS 39301-4158 | 2014-06-03 |
| 1285046987 | Medical Foundation, Inc. | Obstetrics & Gynecology | 1221 24th Ave, Meridian, MS 39301-3926 | 2014-05-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEDICAL FOUNDATION, INC. | 1314 19th Ave, Meridian, MS 39301-4116 |
| Street Address |
1800 12TH ST |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710986591 | Richard S. Abney | Internal Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2005-07-14 |
| 1962057950 | Charles D Lafleur | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2019-08-06 |
| 1255806329 | Delois Darlene Ortego | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2018-10-04 |
| 1003334301 | Amanda Danielle Simpson | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2017-09-07 |
| 1689119851 | Medical Arts Surgical Group | Surgery | 1800 12th St, Meridian, MS 39301-4158 | 2016-12-27 |
| 1053866681 | Alisha L Miller | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2016-08-24 |
| 1356791982 | Trenton Hughes | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2016-06-14 |
| 1588037972 | Kristen Mcpherson | Nurse Practitioner | 1800 12th St, Meridian, MS 39301 | 2015-11-05 |
| 1275910663 | Rush Medical Foundation | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2015-05-05 |
| 1801294772 | Donald Jason Farrar | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2014-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124010640 | Gary G. Gordon | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1467921825 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 2781 C T Switzer Sr Drive, Suite 308, Biloxi, MS 39531 | 2018-11-15 |
| 1295224954 | Flora Physicians, Pllc | Family Medicine | 4848 Main St, Flora, MS 39071-9515 | 2018-05-08 |
| 1265803985 | Mississippi Phs Md LLC | Family Medicine | 232 Market St, Flowood, MS 39232-3339 | 2015-10-08 |
| 1609187152 | Rebecca E Hollingsworth | Family Medicine | 20 Rawls Springs Loop Rd, Hattiesburg, MS 39402-7801 | 2010-06-30 |
| 1104076645 | Ashley Wayne Harris | Family Medicine | 845 S Madison St, Tupelo, MS 38801-4905 | 2008-09-20 |
| 1255447900 | Donald D. Weaver | Family Medicine | 1612 31st Ave, Gulfport, MS 39501-2750 | 2006-08-22 |
| 1659388585 | John Phenis Hey IIi | Family Medicine | 405 River Rd, Greenwood, MS 38930-4212 | 2006-08-02 |
| 1841206760 | Robert H Pierce | Family Medicine | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2006-07-31 |
| 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.