DENA W JACKSON (NPI# 1477663318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477663318 |
| Entity Type | Individual |
| Full Name | DENA W JACKSON |
| Credential | M.D. |
| Practice Address |
940 Brookway Blvd Brookhaven MS 39601-2644 |
| Practice Telephone | 6018235000 |
| Practice Fax Number | 6018234140 |
| Mailing Telephone | 6018235000 |
| Mailing Fax Number | 6018234140 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 15989 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RR MEDICARE | P01402452 | 01 |
| MS | 00124165 | 05 |
| Street Address |
940 BROOKWAY BLVD |
| City | BROOKHAVEN |
| State | MS |
| Zip Code | 39601-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679107692 | Tucker Lee Brady | Nurse Practitioner | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2020-02-28 |
| 1326575069 | Daniel Moore | Nurse Practitioner | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2017-05-12 |
| 1760814370 | Karen Wallace Freeman | Pharmacist | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2013-08-06 |
| 1821420431 | April Matthews | Pharmacist | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2013-08-06 |
| 1518299213 | Karla Adams Gerald | Nurse Practitioner | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2010-02-04 |
| 1518130392 | Craig D. Berteau | Psychiatry & Neurology | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2008-04-11 |
| 1225147135 | Ramiro A Montalvo Jr. | Internal Medicine | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2006-08-30 |
| 1013026947 | Tonya C Hughey | Nurse Practitioner | 940 Brookway Blvd, Brookhaven, MS 39601-2644 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329633 | Mary Lindsey Lumley | Nurse Practitioner | 620 Hwy 51, Brookhaven, MS 39601 | 2020-09-01 |
| 1306371687 | Rocky Mountain Holdings, LLC | Ambulance | 411 Highway 51 N, Brookhaven, MS 39601 | 2017-04-25 |
| 1043759269 | Candace C Turner | Counselor | 860 E River Pl Suite 100, Jackson, MS 39601 | 2017-02-21 |
| 1619419694 | Therapy Nook PC | Speech-Language Pathologist | 520 Schwem Avenue, Brookhaven, MS 39601 | 2016-11-08 |
| 1851742639 | Melanie Smith | Specialist/Technologist | 325 Low Water Lane, Brookhaven, MS 39601 | 2016-06-23 |
| 1134597107 | Passionate Care Home Health,llc | Home Health | 537 St Charles Places, Brookhaven, MS 39601 | 2015-09-09 |
| 1205218690 | Nurse Practitioner Professionals, Pllc | Clinic/Center | 427 Highway 51 Se, Kings Daughters Medical Center-wound Healing Center, Brookhaven, MS 39601 | 2015-06-23 |
| 1043639289 | Joseph S Moak Jr Md Pa | Internal Medicine | 1040 Biglane Drive, Brookhaven, MS 39601 | 2014-04-15 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1386930113 | Hospice Advantage, LLC. | Hospice Care, Community Based | 120 W Cherokee St, Brookhaven, MS 39601 | 2011-06-20 |
| Find all providers in zip 39601 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427544220 | Hillard Weinstock | Internal Medicine | 12 Corporate Blvd Ne, Brookhaven, GA 30329-1909 | 2018-07-03 |
| 1578079513 | William Alexander | Internal Medicine | 4170 Ashford Dunwoody Rd Ne Ste 100, Brookhaven, GA 30319-1457 | 2017-12-27 |
| 1043639289 | Joseph S Moak Jr Md Pa | Internal Medicine | 1040 Biglane Drive, Brookhaven, MS 39601 | 2014-04-15 |
| 1639495492 | John Leatherbury Allen | Internal Medicine | 3853 Byrnwyck Pl Ne, Brookhaven, GA 30319-1658 | 2010-04-19 |
| 1255593265 | Blaine Cooper Britt | Internal Medicine | 950 Brookway Blvd, Brookhaven, MS 39601-2644 | 2008-06-30 |
| 1760696298 | George L Rodriguez Md PC | Internal Medicine | 8 W Brookhaven Rd, Suite B, Brookhaven, PA 19015-1629 | 2007-05-10 |
| 1184762585 | Carolyn H. Sigman | Internal Medicine | 3925 Peachtree Rd Ne, Suite 300, Brookhaven, GA 30319-5256 | 2007-02-01 |
| 1649327594 | Bradley David Shepherd | Internal Medicine | 1001 Summit Blvd Ste 200, Brookhaven, GA 30319-6410 | 2007-01-04 |
| 1619087541 | Charles A Kergosien | Internal Medicine | 527 Silver Cross Dr, Brookhaven, MS 39601-2388 | 2006-08-30 |
| 1083628291 | James E Roberts | Internal Medicine | 439 N Jackson St Ste D, Brookhaven, MS 39601-2912 | 2006-07-27 |
| Find all providers in BROOKHAVEN | ||||
| City | BROOKHAVEN |
| Zip Code | 39601 |
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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.