ADVANCED DIABETES MANAGEMENT CENTER LLC (NPI# 1528465424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528465424 |
| Entity Type | Organization |
| Organization Name | ADVANCED DIABETES MANAGEMENT CENTER LLC |
| Practice Address |
449 Gloster Creek Suite H-9 Tupelo MS 38801-0000 |
| Practice Telephone | 6628427840 |
| Practice Fax Number | 6628427873 |
| Mailing Telephone | 6628427840 |
| Mailing Fax Number | 6628427873 |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2015-01-27 |
| Authorized Official Name | NATIVEL COLLINS (NP/OWNER) |
| Authorized Official Telephone | 6628427840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R873068 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
449 GLOSTER CREEK SUITE H-9 |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336789387 | Michelle Gardner Briley | Nurse Practitioner | 341 E Main St Ste A1, Tupelo, MS 38804-4040 | 2020-01-07 |
| 1891347522 | Lisa Pierce | Nurse Practitioner | 913 Holly Hill Dr, Tupelo, MS 38801-2361 | 2019-07-12 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1992234959 | Pro Health Clinic,llc | Nurse Practitioner | 4127 W Main St, Tupelo, MS 38801-8129 | 2017-06-05 |
| 1053845610 | Precious Montgomery | Nurse Practitioner | 173 Carr Vista Rd, Tupelo, MS 38801-8604 | 2017-04-20 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1699051508 | Angela Sima Clegg | Nurse Practitioner | 942 Commonwealth Blvd, Tupelo, MS 38804-9762 | 2011-10-25 |
| 1427299213 | Kathi Ann Hood Tomsky | Nurse Practitioner | 2071 S Green St, Tupelo, MS 38804-6512 | 2009-03-09 |
| 1922271600 | Dortha Leona Carnathan | Nurse Practitioner | 910 Mary Vance Dr, Tupelo, MS 38801 | 2008-04-02 |
| Find all providers in TUPELO | ||||
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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.