FRESENIUS MEDICAL CARE SW JACKSON HOME, LLC (NPI# 1396011458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396011458 |
| Entity Type | Organization |
| Organization Name | FRESENIUS MEDICAL CARE SW JACKSON HOME, LLC |
| Other Organization Name | FRESENIUS MEDICAL CARE SW JACKSON HOME |
| Practice Address |
1421 N State St Suite 501 Jackson MS 39202-1658 |
| Practice Telephone | 6012921545 |
| Practice Fax Number | 6012921546 |
| Mailing Telephone | 6012921545 |
| Mailing Fax Number | 6012921546 |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |
| Authorized Official Name | MARK R FAWCETT (TREASURER) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
MS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fresenius Medical Care SW Jackson Home | Doing Business As Name - Organization |
| Street Address |
1421 N STATE ST SUITE 501 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649268822 | Billy W Long | Internal Medicine | 1421 N State St, Suite 203, Jackson, MS 39202-1658 | 2005-10-11 |
| 1730480286 | Melissa Jones | Registered Nurse | 1421 N State St, Suite 403, Jackson, MS 39202-1658 | 2010-11-14 |
| 1710288410 | Kerex LLC | Durable Medical Equipment & Medical Supplies | 1421 N State St, 505, Jackson, MS 39202-1658 | 2010-11-11 |
| 1144532391 | Mark Runnels | Urology | 1421 N State St, Ste 403, Jackson, MS 39202-1658 | 2010-07-03 |
| 1790911048 | Specialty Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1421 N State St, Suite 203, Jackson, MS 39202-1658 | 2009-06-01 |
| 1881849651 | Mary K Gravel | Nurse Anesthetist, Certified Registered | 1421 N State St, Suite 203, Jackson, MS 39202-1658 | 2008-11-20 |
| 1609043363 | Catherine B. Ramsey | Nurse Anesthetist, Certified Registered | 1421 N State St, Suite 203, Jackson, MS 39202-1658 | 2008-05-13 |
| 1427230168 | Fred L Mcmillan, Md, Pllc | Ophthalmology | 1421 N State St, Suite 503, Jackson, MS 39202-1658 | 2007-12-05 |
| 1679769491 | Allen Mcneil Haraway | Urology | 1421 N State St, Suite 400, Jackson, MS 39202-1658 | 2007-09-16 |
| 1528263936 | John Donald Adams Jr. | Urology | 1421 N State St, Suite 403, Jackson, MS 39202-1658 | 2007-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1417481755 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 656 N State St, Jackson, MS 39202-3303 | 2017-04-13 |
| 1619274610 | Total Renal Care Inc | Clinic/Center | 46 Harts Bridge Road, Jackson, TN 38301-0000 | 2011-02-28 |
| 1770711509 | Fresenius Medical Care Kidney and Hypertension, LLC | Clinic/Center | 128 N Elm Ave, Jackson, MI 49202-3502 | 2009-07-01 |
| 1720220213 | Ara-jackson Dialysis LLC | Clinic/Center | 3 Acy Ave, Suite B, Jackson, OH 45640-9561 | 2009-03-30 |
| 1912166778 | Bio-medical Applications of Ohio Inc | Clinic/Center | 820 Veterans Dr, Jackson, OH 45640-2411 | 2008-06-06 |
| 1548489149 | Synergy Dialysis Associates, LLC | Clinic/Center | 500 Mccarty Ln, Jackson, OH 45640 | 2007-04-24 |
| 1245324045 | Rai Care Centers of Michigan I, LLC | Clinic/Center | 200 South East Ave., Jackson, MI 49201-2414 | 2006-10-03 |
| 1013019215 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 1550 Highway 15 S Ste 30, Jackson, KY 41339-9221 | 2006-09-01 |
| 1518079359 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 2995 Race St, Jackson, LA 70748-5839 | 2006-08-31 |
| 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.