DR. KENNETH I CRONIN (NPI# 1619981644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619981644 |
| Entity Type | Individual |
| Full Name | DR. KENNETH I CRONIN |
| Credential | M.D. |
| Practice Address |
408 Fontaine Pl Suite 104 Ridgeland MS 39157-5145 |
| Mailing Address |
123a Highway 80 E Suite 248 Clinton MS 39056-4738 |
| Practice Telephone | 6019241744 |
| Practice Fax Number | 6019247406 |
| Mailing Telephone | 6019241744 |
| Mailing Fax Number | 6019247406 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-02-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
06996 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06823544 | 05 |
| Street Address |
408 FONTAINE PL SUITE 104 |
| City | RIDGELAND |
| State | MS |
| Zip Code | 39157-5145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932251683 | Three Oaks Behavioral Health of Ridgeland, LLC | Psychiatric Hospital | 408 Fontaine Pl, Suite 101, Ridgeland, MS 39157-5145 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1225680945 | Verthena Edwards | Home Health | 301 Pinehurst Cir, N/a, Ridgeland, MS 39157 | 2019-07-12 |
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1841786365 | Whitney Paige Crum | Speech-Language Pathologist | Laskin Therapy Group Pa, 207 W Jackson St, Ridgeland, MS 39157 | 2018-07-09 |
| 1811487002 | Camille Brockett | Social Worker | 270 Trace Colony Park Dr Ste B, Ridgeland, MS 39157 | 2018-05-14 |
| 1588171177 | Layson Counseling Group, Pllc | Counselor | 573 Hwy 51 Suite B, Ridgeland, MS 39157 | 2018-01-04 |
| 1407376452 | Mobility Rehab LLC | Clinic/Center | 745 S Pear Orchard Road, Apt 335, Ridgeland, MS 39157 | 2017-06-21 |
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1851755714 | Jerlunda Lynn Dudley | Social Worker | 511 Clark Street, Rosedale, MS 39157 | 2016-04-07 |
| Find all providers in zip 39157 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1487179156 | Pathway Healthcare - Jackson, Ms, LLC | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2017-08-03 |
| 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 |
| 1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
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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.