DHP OF DESOTO PROFESSIONAL ASSOCIATION (NPI# 1770830077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770830077 |
| Entity Type | Organization |
| Organization Name | DHP OF DESOTO PROFESSIONAL ASSOCIATION |
| Practice Address |
7601 Southcrest Pkwy Southaven MS 38671-4739 |
| Mailing Address |
265 Brookview Centre Way Suite 400 Knoxville TN 37919-4052 |
| Practice Telephone | 6627724000 |
| Mailing Telephone | 8656931000 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |
| Authorized Official Name | DR. RANDAL DABBS (PRESIDENT) |
| Authorized Official Telephone | 8656931000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
7601 SOUTHCREST PKWY |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637090 | Cunningham Physical Medicine | Physical Medicine & Rehabilitation | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2005-05-24 |
| 1598395501 | Raymond Bennett Caldwell Iv | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2020-01-17 |
| 1245871847 | Tammy Q Reed | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2019-10-04 |
| 1871078436 | Catherine R Stepter | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-30 |
| 1669955423 | Tannisha Monique Loggins | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-07 |
| 1982185609 | Gloria S. Hicks | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-08-22 |
| 1326531229 | John Walker | Registered Nurse | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-06-14 |
| 1750871299 | Alejandro Polania | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1528558061 | Deera Warren | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671 | 2018-05-10 |
| 1871083386 | Kenneth A Krzyzkowski | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619526852 | Msk Group, PC | Orthopaedic Surgery | 7900 Airways Blvd Bldg B102, Southaven, MS 38671-4118 | 2019-09-10 |
| 1902969751 | The Office of Bone and Joint Surgery, P.C. | Orthopaedic Surgery | 7900 Airways Blvd Bldg A1, Southaven, MS 38671-4116 | 2006-12-19 |
| 1376557892 | Earl Lynn Phillips | Orthopaedic Surgery | Msk Group, PC, 7900 Airways Blvd, Ste. B102, Southaven, MS 38671 | 2006-07-28 |
| 1699761387 | Gregory D Dabov | Orthopaedic Surgery | 7545 Airways Blvd, Southaven, MS 38671-5806 | 2005-09-27 |
| 1013278084 | William Jacob Weller | Orthopaedic Surgery | 7545 Airways Blvd, Southaven, MS 38671-5806 | 2012-06-06 |
| 1114175585 | Mid-south Orthopedic Hospitalists LLC | Orthopaedic Surgery | 7535 Airways Blvd, Southaven, MS 38671-5834 | 2008-08-28 |
| 1437299344 | Mississippi Orthopaedics & Sports Medicine, Pllc | Orthopaedic Surgery | 391 Southcrest Cir, Suite 205, Southaven, MS 38671-6730 | 2007-02-08 |
| 1124106133 | Timothy J Micek | Orthopaedic Surgery | 3964 Goodman Rd E, Suite 128, Southaven, MS 38672-8761 | 2006-11-01 |
| 1932121662 | Claiborne Ashby Christian | Orthopaedic Surgery | 7580 Clarington Cv, Southaven, MS 38671-5657 | 2006-07-24 |
| 1407813736 | John Tom Morris Jr. | Orthopaedic Surgery | 7580 Clarington Cv, Southaven, MS 38671-5657 | 2006-04-28 |
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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.