DR. JASON KENNETH COLEMAN (NPI# 1477665065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477665065 |
Entity Type | Individual |
Full Name | DR. JASON KENNETH COLEMAN |
Credential | DMD |
Practice Address |
3964 Goodman Rd E Suite 128 Southaven MS 38672-8761 |
Mailing Address |
4036 Robertson Gin Rd Hernando MS 38632-8228 |
Practice Telephone | 6628937337 |
Practice Fax Number | 6628937881 |
Mailing Telephone | 6624293419 |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3112-99 | MS | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00660436 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831708221 | Jason Coleman | Physical Medicine & Rehabilitation | 208 University Dr, West Liberty, WV 26074-1082 | 2020-07-30 |
1467949099 | Jason Coleman | Home Health | 3271 Faronia St, Pittsburgh, PA 15204-2144 | 2018-04-19 |
1356631428 | Jason R Coleman | Pharmacist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2011-04-11 |
1578633301 | Jason Channing Coleman | Pediatrics | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2006-11-09 |
1871663773 | Jason D Coleman | Chiropractor | 8132 Cordova Rd, Suite 102, Cordova, TN 38016-6005 | 2006-11-08 |
1245241538 | Jason W Coleman | Nurse Anesthetist, Certified Registered | 2124 14th St, Meridian, MS 39301-4040 | 2006-08-11 |
Street Address |
3964 GOODMAN RD E SUITE 128 |
City | SOUTHAVEN |
State | MS |
Zip Code | 38672-8761 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508869462 | Adam Brooks Risinger | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2005-05-24 |
1215383773 | Cody Semler | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2016-05-13 |
1700253481 | Anna Fee | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2015-08-28 |
1568870715 | Blake Hobbs | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2014-07-31 |
1083025001 | Lacey Moody | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2014-05-13 |
1396031332 | Cameron B Pikula | Physical Therapist | 3964 Goodman Rd E, Ste 111, Southaven, MS 38672-8761 | 2011-06-28 |
1235438078 | Unity Hospice Ne, LLC | Hospice Care, Community Based | 3964 Goodman Rd E, Ste 112, Southaven, MS 38672-8761 | 2011-03-18 |
1649595117 | Kevin Francis Yekaitis | Nurse Practitioner | 3964 Goodman Rd E, Southaven, MS 38672-8761 | 2010-03-29 |
1124106133 | Timothy J Micek | Orthopaedic Surgery | 3964 Goodman Rd E, Suite 128, Southaven, MS 38672-8761 | 2006-11-01 |
1811928823 | Brett Allen Rivers | Physical Therapist | 3964 Goodman Rd E, Suite 111, Southaven, MS 38672-8761 | 2006-07-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
1356713606 | Deadra Dennis | Behavioral Analyst | 2816 Calico Rock Cv, Southaven, MS 38672 | 2015-10-27 |
1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
1659516524 | Stacy L Sanders | Audiologist | 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 | 2008-12-08 |
1295927226 | Tracey F Petrides | Family Medicine | 5779 Getwell Road, Building D, Suite 3, Southaven, MS 38672 | 2007-08-14 |
1538288741 | Bruce A Denney | Dentist | 7125 Getwell Road, Suite 102, Southaven, MS 38672 | 2007-03-28 |
1154480150 | Kimberly Marie Metcalf | Social Worker | 7165-g Getwell Rd., Southaven, MS 38672 | 2006-12-06 |
1346318441 | Deborah Verucchi | Nurse Practitioner | 5740 Getwell Rd Ste B, Southaven, MS 38672 | 2006-11-30 |
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Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588787931 | Charles Walker Mccrary | Dentist | 730 Goodman Rd E, Ste B, Southaven, MS 38671-9530 | 2007-04-09 |
1649336017 | Steven J Fuson | Dentist | 7734 Airways, Southaven, MS 38671 | 2006-12-29 |
1639235963 | Dormois & Fuson, P.l.l.c. | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
1194825299 | Clyde Armstrong Musgrave | Dentist | 3964 Goodman Rd E Ste 128, Southaven, MS 38672-6494 | 2006-09-25 |
1720341100 | Nathaniel D Denson | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2012-06-20 |
1134285455 | John C Page | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
1841356169 | John A Acosta | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
1578658373 | North Mississippi Dental Specialists, Pllc | Dentist | 3964 Goodman Rd E Ste 128, Southaven, MS 38672-6494 | 2006-10-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164938650 | Pediatric Dentistry of Corinth | Dentist | 1500 N Harper Rd #5, Pediatric Dentistry of Corinth, Corinth, MS 38834 | 2017-12-19 |
1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
1669850004 | Jcc, LLC | Dentist | 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 | 2015-05-18 |
1871971101 | Katherine Curtis Windham | Dentist | 300 Hospital Dr Ste 3, Columbus, MS 39705-1921 | 2015-05-06 |
1740673797 | Emilee Peeples Milling | Dentist | 1855 Crane Ridge Dr Ste 2, Jackson, MS 39216-4944 | 2015-03-16 |
1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
1710327960 | Maegen Calhoun Mccabe | Dentist | 11280 E Taylor Rd, Suite B, Gulfport, MS 39503-4038 | 2013-07-02 |
1215280672 | Reggie H. Broom, D.m.d., P.a. | Dentist | 1635 E Pass Rd, Gulfport, MS 39507-3527 | 2012-10-23 |
1316216716 | Middleton & Belknap Pediatric Dentistry Pllc | Dentist | 6643 U S Highway 98, Hattiesburg, MS 39402-8442 | 2011-12-14 |
1194004994 | Eric L. Hyde, Dds, Pllc | Dentist | 15236 Dedeaux Rd, Gulfport, MS 39503-3161 | 2011-08-10 |
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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.