SHAWN SANDERS (NPI# 1629207170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629207170 |
Entity Type | Individual |
Full Name | SHAWN SANDERS |
Practice Address |
501 Marshall St Ste 104 Jackson MS 39202-1663 |
Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
Practice Telephone | 6019696404 |
Practice Fax Number | 6019734541 |
Mailing Telephone | 9012273255 |
Enumeration Date | 2009-07-06 |
Last Update Date | 2018-03-12 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
22036 | MS | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
2500 N State St, Jackson, MS 392164500 | 6019845601 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720471998 | Shawn Sanders | Developmental Therapist | 3858 N Camelot Dr, Apt 3b, Decatur, IL 62526-2057 | 2015-03-12 |
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 |
1508206913 | Stephen David Anderson | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-06-28 |
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 |
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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 |
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Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467494070 | Apex Cardiology PC | Internal Medicine | 327 Summar Dr, Jackson, TN 38301-3930 | 2006-06-11 |
1053970624 | Jackson Cardiology Consultants Pllc | Internal Medicine | 205 Page Ave, Jackson, MI 49201-2462 | 2019-06-07 |
1053873133 | Cms Care of Ms, LLC | Internal Medicine | 460 Briarwood Dr Ste 400, Jackson, MS 39206-3062 | 2019-04-05 |
1497292361 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
1841602257 | Mississippi Vascular Center, Pllc | Internal Medicine | 571 E Beasley Rd, Jackson, MS 39206-3042 | 2014-05-20 |
1558523464 | Montoya Taylor | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2008-07-01 |
1679506547 | Tommy L. Miller IIi | Internal Medicine | 48 Medical Center Dr, Jackson, TN 38301-3947 | 2006-07-07 |
1811939424 | Henry K S Lui | Internal Medicine | 327 Summar Dr, Jackson, TN 38301-3930 | 2006-06-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134761786 | Cardiovascular Health Center Pllc | Internal Medicine | 4211 Hospital St Ste 202, Pascagoula, MS 39581-5310 | 2019-10-16 |
1497224174 | Fusion Vascular, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732-3502 | 2018-11-25 |
1679730329 | Foluso A Fakorede | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2008-05-20 |
1073617775 | Jimmy Darrell Sneed | Internal Medicine | 391 Southcrest Cir Ste 200, Southaven, MS 38671-6729 | 2006-09-12 |
1245214196 | Hemraj R. Makwana | Internal Medicine | 520 Willowbrook Rd, Columbus, MS 39705-2015 | 2005-12-05 |
1720087257 | Joon K Chang | Internal Medicine | 255 Baptist Blvd, Ste. 401, Columbus, MS 39705-2011 | 2005-07-18 |
1154989689 | King and Associates Cardiology Pllc | Internal Medicine | 2323 5th St N, Columbus, MS 39705-2213 | 2019-05-30 |
1760975692 | Fusion Vascular Center, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732 | 2018-06-14 |
1356712848 | Cardiovascular Solutions of Central Ms Pa | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2015-10-09 |
1427439348 | Corinth Cardiovascular Care, Pllc | Internal Medicine | 2427 Proper St, Corinth, MS 38834-5394 | 2015-06-16 |
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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.