JONATHAN S. C. CAUDILL (NPI# 1538131594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538131594 |
| Entity Type | Individual |
| Full Name | JONATHAN S. C. CAUDILL |
| Credential | M.D. |
| Practice Address |
1203 Medical Park Dr Oxford MS 38655-5327 |
| Practice Telephone | 6625134399 |
| Mailing Telephone | 6625134399 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-02-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 18119 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 590057300 | 05 |
| Street Address |
1203 MEDICAL PARK DR |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988580 | Adriana Lyn Jenkins | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2019-08-21 |
| 1407328412 | Leslie Bensieck | Social Worker | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2019-01-02 |
| 1972080257 | Right Track Medical Group, Inc | Psychiatry & Neurology | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2018-07-19 |
| 1932590452 | Mallory Mckenzie Warrington Wills | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2015-02-06 |
| 1992139976 | Jamie Vice Fortner | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2013-08-27 |
| 1568757201 | James Edward Warrington IIi | Student in an Organized Health Care Education/Training Program | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2011-06-10 |
| 1215245931 | Meggan Hanson Blaylock | Counselor | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2010-09-15 |
| 1992035000 | Kathryn K Wiygul | Nurse Practitioner | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2010-01-12 |
| 1407917453 | Molly Simpson Singletary | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2006-12-13 |
| 1639230675 | William Douglas Sanford Jr. | Pediatrics | 1203 Medical Park Dr, Oxford, MS 38655-5327 | 2006-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| 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 |
|---|---|---|---|---|
| 1508464181 | Meredith Sanford | Pediatrics | 101 Farm View Dr, Oxford, MS 38655-7728 | 2020-10-15 |
| 1477870822 | Catherine Durst Phillips | Pediatrics | 2682 W Oxford Loop Ste 130, Oxford, MS 38655-5441 | 2010-04-26 |
| 1295960623 | Harry Goff Carpenter Jr. | Pediatrics | 5 Loon Ln, Oxford, ME 04270-4836 | 2009-05-29 |
| 1457447815 | Robert T Carsley | Pediatrics | 230 Timber Ln, Oxford, MS 38655-5850 | 2006-10-05 |
| 1366451049 | Tanya Jean Fitts | Pediatrics | 2166 S Lamar Blvd, Oxford, MS 38655-5224 | 2006-08-05 |
| 1467475202 | Joseph Anthony Dieterle Jr. | Pediatrics | 112 First St., Oxford, MD 21654-0532 | 2006-07-25 |
| 1477551042 | William J Logeman | Pediatrics | 5141 Morning Sun Rd, Oxford, OH 45056-9629 | 2005-07-08 |
| 1093713695 | Granville Family Medicine Pa | Pediatrics | 103 Professional Park Ste A, Oxford, NC 27565-2581 | 2005-07-08 |
| 1487205829 | Phillips Pediatrics, LLC | Pediatrics | 2682 W Oxford Loop Ste 130, Oxford, MS 38655-5441 | 2019-09-26 |
| 1699288829 | Envision Children's Healthcare Services of North Mississippi, Inc. | Pediatrics | 2301 S Lamar Blvd, Oxford, MS 38655-5373 | 2017-11-09 |
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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.