PATHWAY HEALTHCARE - JACKSON, MS, LLC (NPI# 1487179156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487179156 |
| Entity Type | Organization |
| Organization Name | PATHWAY HEALTHCARE - JACKSON, MS, LLC |
| Practice Address |
1551 E County Line Rd Jackson MS 39211-1801 |
| Mailing Address |
1000 Urban Center Dr Ste 600 Vestavia AL 35242-2584 |
| Practice Telephone | 7312656025 |
| Practice Fax Number | 7312656028 |
| Mailing Telephone | 2052089312 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2020-05-28 |
| Authorized Official Name | MELISSA COX (CREDENTIALING) |
| Authorized Official Telephone | 2052089312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1551 E COUNTY LINE RD |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164518874 | John Thomas Barringer | Internal Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2006-10-04 |
| 1093228702 | Sentral B Brown | Social Worker | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2017-11-16 |
| 1962915678 | Andrea Farrar | Social Worker | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2017-11-16 |
| 1699140152 | Restore Health Pllc | Clinic/Center | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2015-12-09 |
| 1982979977 | Pamela Teresa Moore | Nurse Practitioner | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2012-03-09 |
| 1114223500 | On Demand Lab Test LLC | Clinical Medical Laboratory | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2011-02-01 |
| 1033394358 | Jeffrey Bryan Hickman | Counselor | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2008-01-05 |
| 1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
| 1558586792 | Wl Aron Md Pa | Clinic/Center | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
| 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 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1487185153 | Impact Healthcare Pllc | Family Medicine | 37 Sandstone Cir, Ste 92, Jackson, TN 38305-2089 | 2017-03-24 |
| 1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245755990 | Pathway Healthcare- Columbus, Ms LLC | Family Medicine | 3600 Bluecutt Rd Ste 200, Columbus, MS 39705-1303 | 2017-08-03 |
| 1124471131 | 1st Step Medical PC | Family Medicine | 3104 Adams Farm Rd, Belden, MS 38826-7020 | 2016-07-14 |
| 1619981644 | Kenneth I Cronin | Family Medicine | 408 Fontaine Pl, Suite 104, Ridgeland, MS 39157-5145 | 2006-07-27 |
| 1619433943 | Live Oaks Addiction Professionals | Family Medicine | 5699 Getwell Rd Ste 1, Southaven, MS 38672-7312 | 2019-02-12 |
| 1013425503 | Pathway Healthcare- Mississippi LLC | Family Medicine | 1 Medical Plaza Dr, Vicksburg, MS 39180-5187 | 2018-01-18 |
| 1336656628 | Pathway Healthcare- Columbus, Ms LLC | Family Medicine | 3600 Bluecutt Rd Ste 200, Columbus, MS 39705-1303 | 2018-01-08 |
| 1215451794 | West Mississippi Medical Services | Family Medicine | 100 Mcauley Dr, Vicksburg, MS 39183-2825 | 2017-07-27 |
| 1376929901 | Sw Mediacal Inc | Family Medicine | 2561 Pass Rd, Suite D, Biloxi, MS 39531-2125 | 2015-08-05 |
Please comment or provide details below to improve the information on PATHWAY HEALTHCARE - JACKSON, MS, LLC.
| 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.