JACKSON PSYCHIATRY GROUP (NPI# 1790087393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790087393 |
| Entity Type | Organization |
| Organization Name | JACKSON PSYCHIATRY GROUP |
| Practice Address |
1855 Lakeland Dr Suite P121 Jackson MS 39216-4913 |
| Practice Telephone | 6013664696 |
| Practice Fax Number | 8667721223 |
| Mailing Telephone | 6013664696 |
| Mailing Fax Number | 8667721223 |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2011-03-30 |
| Authorized Official Name | MR. DOUG W. BYRD (PRESIDENT) |
| Authorized Official Telephone | 6013664696 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
15999 | MS | Behavioral Health & Social Service Providers |
| Street Address |
1855 LAKELAND DR SUITE P121 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508812694 | Mchanna & Associates, Inc. | Durable Medical Equipment & Medical Supplies | 1855 Lakeland Dr, Suite R204, Jackson, MS 39216-4913 | 2006-05-26 |
| 1104423268 | Emily Goeglein | Counselor | 1855 Lakeland Dr, Jackson, MS 39216-4913 | 2020-10-02 |
| 1972051522 | Daniel James Holloway | Nurse Practitioner | 1855 Lakeland Dr, Suite P-101, Jackson, MS 39216-4913 | 2016-09-13 |
| 1992161954 | Enhanced Wellness Living Pllc | Nurse Practitioner | 1855 Lakeland Dr, Ste M20, Jackson, MS 39216-4913 | 2016-01-06 |
| 1730552977 | Kaleigh Countiss | Counselor | 1855 Lakeland Dr, R305, Jackson, MS 39216-4913 | 2015-11-10 |
| 1104166891 | Lisa L Dalton | Nurse Practitioner | 1855 Lakeland Dr, Ste M20, Jackson, MS 39216-4913 | 2013-02-18 |
| 1174804355 | Portable Medical Diagnostics LLC | Clinic/Center | 1855 Lakeland Dr, Ste G10, Jackson, MS 39216-4926 | 2011-09-01 |
| 1932489812 | Portable Medical Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1855 Lakeland Dr, Ste G10, Jackson, MS 39216-4913 | 2011-08-23 |
| 1003119041 | Denease Inez Bishop | Counselor | 1855 Lakeland Dr, Suite P101, Jackson, MS 39216-4913 | 2010-12-14 |
| 1629378971 | Pmt Clinic | Psychologist | 1855 Lakeland Dr, Suite P101, Jackson, MS 39216-4913 | 2010-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629378971 | Pmt Clinic | Psychologist | 1855 Lakeland Dr, Suite P101, Jackson, MS 39216-4913 | 2010-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447886502 | Rico Smith | Psychologist | 314 E Green St, Macon, MS 39341-2850 | 2020-03-19 |
| 1588846281 | Behavioral Medicine Clinic,pa | Psychologist | 5000 Hwy 39 N, Meridian, MS 39301-1021 | 2007-12-04 |
| 1922374057 | Toni L Ladner | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2012-03-22 |
| 1225303068 | Mindful Solution, LLC | Psychologist | 1 Commerce Dr, Suite 205, Hattiesburg, MS 39402-1499 | 2012-03-13 |
| 1558580662 | Beverly Tedford | Psychologist | 601 Foote St, Corinth, MS 38834-4834 | 2007-04-25 |
| 1386860898 | Wellness Clinic, P.C. | Psychologist | 5740 Getwell Rd, Bldg 4c, Southaven, MS 38672-6346 | 2007-04-17 |
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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.