DR. STEPHEN DAVID ANDERSON (NPI# 1508206913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508206913 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN DAVID ANDERSON |
| Credential | M.D. |
| Practice Address |
501 Marshall St Ste 104 Jackson MS 39202-1663 |
| Mailing Address |
Po Box 2153 Dept 1947 Birmingham AL 35287-0001 |
| Practice Telephone | 6019696404 |
| Practice Fax Number | 6019734541 |
| Mailing Telephone | 6019696404 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
24122 | MS | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 N State St, Jackson, MS 39216 | 6019845601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1740640143 | Stephen Craig Anderson | Registered Nurse | 626 Prichett Ct, Fort Collins, CO 80525-8229 | 2016-02-26 |
| 1689905036 | Stephen Christian Anderson | Social Worker | 525 S Melendres St, Las Cruces, NM 88005-2805 | 2010-01-25 |
| 1366680696 | Stephen Russell Anderson | Psychologist | 8297 Old Post Rd E, East Amherst, NY 14051-1530 | 2009-01-23 |
| 1720276520 | Stephen E Anderson | Marriage & Family Therapist | 2940 Summit St Ste 2a, Oakland, CA 94609-3416 | 2007-10-05 |
| 1861415960 | Stephen Craig Anderson | Dentist | 542 Pulaski Rd, Calumet City, IL 60409-4121 | 2006-07-26 |
| 1306867833 | Stephen C Anderson | Internal Medicine | 95 Sargent St, Route 9, Belchertown, MA 01007-9881 | 2006-07-21 |
| 1891753125 | Stephen L Anderson | Social Worker | 1032 S 16th St, Suite 219, Milwaukee, WI 53204 | 2006-05-03 |
| 1154948438 | Stephen Anderson | Pharmacist | 4121 Halifax Rd, South Boston, VA 24592-4833 | 2020-07-02 |
| 1508386913 | Stephen Anderson | Student in an Organized Health Care Education/Training Program | 3601 4th St # Ms 9410, Lubbock, TX 79430-0002 | 2017-06-27 |
| Street Address |
501 MARSHALL ST STE 104 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557013 | Frank Nelson Haugland | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2005-09-09 |
| 1760956247 | Siera Cheyenne Shiyou | Physician Assistant | 501 Marshall St Ste 104, Jackson, MS 39202 | 2019-01-17 |
| 1346751195 | Amy Wall | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2017-10-19 |
| 1578946612 | Katherine Tucker | Physician Assistant | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2015-07-07 |
| 1811396971 | Rachel P Hearst | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2014-08-14 |
| 1902235583 | Judith Stallings | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-11-05 |
| 1205178241 | Shanna Amisha Tolbert Craven | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-03-16 |
| 1275897670 | Patrick Ross Thurmond | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-06-29 |
| 1275893638 | Derek Paul De Grijs | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-05-20 |
| 1215249016 | Rishi Ashok Roy | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2010-07-08 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1912143991 | Theophilus James Humphreys | Internal Medicine | 164 W University Pkwy Ste A, Jackson, TN 38305-1621 | 2008-12-23 |
| 1548423114 | Olurotimi Badero | Internal Medicine | 5240 Robinson Rd, Jackson, MS 39204-4134 | 2008-07-03 |
| 1740480961 | Cardiovascular Clinic of West Tn PC | Internal Medicine | 2968 North Highland Avenue, Jackson, TN 38305-3609 | 2007-07-25 |
| 1013112457 | The Cardiovascular Clinic of West Tennessee,p.c. | Internal Medicine | 162 Murray Guard Dr, Suite A, Jackson, TN 38305-3609 | 2007-06-17 |
| 1497829550 | Shawn A Baldwin | Internal Medicine | 27a Medical Center Dr, Jackson, TN 38301-3949 | 2006-11-20 |
| 1083715254 | Kenny K. Charn | Internal Medicine | 201 Clinton Rd, Suite 105, Jackson, CA 95642-2648 | 2006-09-26 |
| 1861590457 | Sandra Speckels Mccearley | Internal Medicine | 970 Lakeland Dr Ste 61, Jackson, MS 39216 | 2006-09-20 |
| 1063425734 | Mabbu Jayakumar | Internal Medicine | 168 W University Pkwy Ste C, Jackson, TN 38305-1624 | 2006-08-14 |
| 1851305429 | Jackson Cardiology Associates, P.a. | Internal Medicine | 971 Lakeland Dr Ste 850, Jackson, MS 39216-4608 | 2006-07-28 |
| 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.