ATTALA EMERGENCY GROUP LLC (NPI# 1407103294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407103294 |
| Entity Type | Organization |
| Organization Name | ATTALA EMERGENCY GROUP LLC |
| Practice Address |
220 Highway 12 W Kosciusko MS 39090-3208 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 6622894311 |
| Mailing Telephone | 3373541153 |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2016-01-14 |
| Authorized Official Name | LISHA C FALK (VP OF CONTRACTING) |
| Authorized Official Telephone | 8008939698 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04627832 | 05 |
| Street Address |
220 HIGHWAY 12 W |
| City | KOSCIUSKO |
| State | MS |
| Zip Code | 39090-3208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063475440 | Mary Katherine Lawrence | Nurse Practitioner | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2006-04-07 |
| 1730689647 | Heather Crouch | Physical Therapy Assistant | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2018-02-16 |
| 1912418419 | Olivia Phillips | Occupational Therapist | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2017-10-24 |
| 1295250926 | Cheyenne Hope Hedden | Physical Therapy Assistant | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2017-08-03 |
| 1629513437 | Kelly Kight | Occupational Therapist | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2017-01-03 |
| 1679025928 | Sandy Heath Cockrell | Occupational Therapy Assistant | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2016-11-02 |
| 1003272337 | Baptist Medical Center Attala LLC | Internal Medicine | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2015-12-31 |
| 1023481595 | Bmc - Attala, LLC | Family Medicine | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2015-11-05 |
| 1811373038 | Sarah Burns | Physical Therapy Assistant | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2015-08-11 |
| 1811224009 | Hospital Care Consultants of Kosciusko | Hospitalist | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2009-11-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508371675 | Caroline Boydstun Fair | Pharmacist | 109 Northside Center, Kosciusko, MS 39090 | 2017-12-11 |
| 1275069643 | Sharhonda Wingo | Speech-Language Pathologist | 2447 Attala Road 2203, Kosciusko, MS 39090 | 2017-05-04 |
| 1013392034 | Leap of Faith LLC | Respite Care | 115 North Wells Street, Suite A, Kosciusko, MS 39090 | 2015-07-21 |
| 1730566027 | Bmc - Attala, LLC | General Acute Care Hospital | 220 Hwy. 12 West, Kosciusko, MS 39090 | 2015-05-06 |
| 1528402484 | Warner Martin Myers I | Student in an Organized Health Care Education/Training Program | 912 Hwy 12 East, Kosciusko, MS 39090 | 2013-04-23 |
| 1891022547 | Medical Foundation of Central Mississippi | Internal Medicine | 329 Highway 12 West, Koscuisko, MS 39090 | 2009-11-17 |
| 1255512448 | Cheryl L Bayne | Adult Companion | 509 Hillview Dr, Kosciusko, MS 39090 | 2007-11-16 |
| 1760673982 | Gary A Cochran | Technician/Technologist | 118 West North St, Kosciusko, MS 39090 | 2007-08-05 |
| 1639396393 | Stephen C Hammack | Family Medicine | 332 Highway 12 West, Kosciusko, MS 39090 | 2007-04-20 |
| 1740329689 | Brenda Nail | Nurse Practitioner | 999 Martin Luther King Drive, Kosciusko, MS 39090 | 2007-02-06 |
| Find all providers in zip 39090 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902868961 | Benjamin Thomas Carter | Emergency Medicine | 332 Highway 12 W, Kosciusko, MS 39090-3209 | 2006-04-05 |
| 1598728586 | Brady L Richardson | Emergency Medicine | 220 Highway 12 W, Kosciusko, MS 39090-3208 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780201145 | Sabrina Marie Azavedo | Emergency Medicine | 3283 Shadowood Ln, Corinth, MS 38834-6030 | 2020-07-01 |
| 1275172736 | Relias Emergency Medicine Specialists of West Point, LLC | Emergency Medicine | 150 Medical Center Dr, West Point, MS 39773-0428 | 2020-01-02 |
| 1790130151 | Patrick Bryant | Emergency Medicine | 5001 Hardy Street, Hattiesburg, MS 39402 | 2016-05-04 |
| 1679935381 | Rommel Asagwara | Emergency Medicine | 1060 E County Line Rd Ste 1a, Ridgeland, MS 39157-1937 | 2016-03-22 |
| 1588034227 | Srikar Karanam | Emergency Medicine | 114 Breckenridge Dr Apt 203, Hattiesburg, MS 39402-3709 | 2015-10-06 |
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1942612015 | Emergency Associates Pllc | Emergency Medicine | 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 | 2014-05-23 |
| 1720362270 | David Kennedy Stone | Emergency Medicine | 102 Pine Ct, Brandon, MS 39047-8313 | 2011-10-03 |
| 1083995674 | Obhg Mississippi, P.C. | Emergency Medicine | 1225 N State St Ste B1, Jackson, MS 39202-2072 | 2011-09-09 |
| 1114238425 | Kevin Lee Beason | Emergency Medicine | 10151 Road 1343, Philadelphia, MS 39350-4101 | 2010-07-01 |
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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.