DR. BRIAN RICHARD DECOSTA (NPI# 1689620627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689620627 |
| Entity Type | Individual |
| Full Name | DR. BRIAN RICHARD DECOSTA |
| Credential | M.D. |
| Practice Address |
367 Hospital Blvd Jackson TN 38305-2080 |
| Mailing Address |
Po Box 11686 Jackson TN 38308-0128 |
| Practice Telephone | 7313000352 |
| Practice Fax Number | 9017532896 |
| Mailing Telephone | 7313000352 |
| Mailing Fax Number | 9017532896 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
36602 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
367 HOSPITAL BLVD |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-2080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922094283 | Julie D Joyce | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Regional Hospital of Jackson, Jackson, TN 38305-2080 | 2005-09-22 |
| 1457824468 | West Tennessee Healthcare Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2019-01-03 |
| 1093188864 | Atlas Emergency Physicians, Pllc | Physician Assistant | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2015-11-03 |
| 1093188971 | Red Embers Emergency Physicians, LLC | Physician Assistant | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2015-11-02 |
| 1215354055 | Jackson Anesthesia and Perioperative Consultants | Anesthesiology | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2014-03-18 |
| 1558797993 | Valley Grove Inpatient Services, Pllc | Internal Medicine | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2013-09-17 |
| 1033456884 | Charity Reasons | Nurse Practitioner | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2013-01-14 |
| 1780965103 | Ashley Dillingham Hayes | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2011-08-30 |
| 1780906560 | Tennessee Em-i Medical Services, PC | Nurse Practitioner | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2010-02-22 |
| 1700063351 | Norberto J Celarie | Emergency Medicine | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2008-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063890754 | Phil Otis Nelson Jr. | Radiology | 146 Ridge Dr, Jackson, MS 39216-4109 | 2015-05-13 |
| 1891030946 | Cherry Hill Radiology Pllc | Radiology | 401 Redfield Dr, Jackson, TN 38305-8555 | 2012-11-30 |
| 1245414275 | Breathit County Imaging Center | Radiology | 1389 Ky Hwy 15 North, St. John Newmans Medical Plaza, Jackson, KY 41339 | 2007-12-27 |
| 1407933930 | Karen Collette Jensen | Radiology | 14 Adams Road, Jackson, NH 03846 | 2006-11-01 |
| 1770676801 | Gerald O Daniel | Radiology | 708 W Forest Avenue, Jackson, TN 38301 | 2006-10-02 |
| 1497761837 | Arlin George Hatfield IIi | Radiology | 1405 North State Street, Suite 200, Jackson, MS 39202 | 2006-07-31 |
| 1225083942 | Robert Houston Hardin Jr. | Radiology | 2210 Heritage Hill Dr, Jackson, MS 39211-5821 | 2006-05-23 |
| 1881655967 | Jane Warne Brown | Radiology | 91 Stonehaven Cir, Jackson, TN 38305-1945 | 2006-03-29 |
| 1780645028 | Andrew Laurence Rivard | Radiology | 2500 State Street, University of Mississippi Medical Center, Jackson, MS 39216 | 2006-03-28 |
| 1013985134 | John A. Sullivan | Radiology | 7330 Ryegrass Road, Jackson, WY 83001 | 2006-03-14 |
| 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.