AUDREY UKACHI ROBERTSON (NPI# 1528154861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528154861 |
| Entity Type | Individual |
| Full Name | AUDREY UKACHI ROBERTSON |
| Credential | MD |
| Practice Address |
514h E Woodrow Wilson Ave Jackson MS 39216-4538 |
| Practice Telephone | 6017133900 |
| Practice Fax Number | 6017133970 |
| Mailing Telephone | 6017133900 |
| Mailing Fax Number | 6017133970 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 15656 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00118818 | 05 | |
| MS | AETNA | 5355653 | 01 |
| MS | UNITED HEALTH CARE | 001819211003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093368383 | Audrey Regan Robertson | Occupational Therapist | 502 E Race Ave, Searcy, AR 72143-4417 | 2019-07-17 |
| 1992089833 | Audrey Elizabeth Robertson | Speech-Language Pathologist | 5402 Arapaho Rd, Dallas, TX 75248-6905 | 2011-10-10 |
| Street Address |
514H E WOODROW WILSON AVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174068704 | Fortenise A Mason | Nurse Practitioner | 514h E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2017-01-06 |
| 1053703132 | Ammy Hutton Davis | Nurse Practitioner | 514h E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2015-02-25 |
| 1922311794 | Monifa Ri'ana Beal | Nurse Practitioner | 514h E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2010-07-21 |
| 1891975603 | Peace Children's Clinic | Clinic/Center | 514h E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2007-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982224895 | Vpa PC | Pediatrics | 111 E Capitol St Ste 215, Jackson, MS 39201-2108 | 2020-04-21 |
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1891145850 | Abdullah Sharaf | Pediatrics | 760 W Franklin St # 49201, Jackson, MI 49201-2048 | 2016-06-20 |
| 1427427152 | Karin L Klee Md | Pediatrics | 555 E Broadway Ave Ste 216, Jackson, WY 83001-8640 | 2015-09-23 |
| 1073992699 | Muna Balkash | Pediatrics | 4645 Eagle Dr, Jackson, MI 49201-9748 | 2015-05-28 |
| 1295147809 | Jayasree Vasudevan Nair | Pediatrics | 100 Mission Blvd Ste 2600, Jackson, CA 95642-2536 | 2014-05-30 |
| 1669891099 | Jacquelin Foss Hardenbrook | Pediatrics | 555 E Broadway Ave Ste 202, Jackson, WY 83001-8640 | 2014-04-14 |
| 1871805093 | Jesse Alfred Miller Jr. | Pediatrics | 1804 Hwy 45 Bypass, Jackson, TN 38305 | 2010-07-02 |
| 1861647489 | Elizabeth Keeling Hensley | Pediatrics | 2046 Petit Bois St S, Jackson, MS 39211-6709 | 2008-11-24 |
| 1942469606 | The Children's Clinic of West Tennessee P.a. | Pediatrics | 264 Coatsland Dr, Jackson, TN 38301-3948 | 2008-06-06 |
| 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.