MISSISSIPPI VASCULAR CENTER, PLLC (NPI# 1841602257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841602257 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI VASCULAR CENTER, PLLC |
| Practice Address |
571 E Beasley Rd Jackson MS 39206-3042 |
| Mailing Address |
Po Box 2057 Ridgeland MS 39158-2057 |
| Practice Telephone | 6018993340 |
| Practice Fax Number | 6018993343 |
| Mailing Telephone | 6018993340 |
| Mailing Fax Number | 6018993343 |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |
| Authorized Official Name | TUNDE OLUTADE (MEMBER) |
| Authorized Official Telephone | 6018993340 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
571 E BEASLEY RD |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-3042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982659264 | Isd Renal Inc | Clinic/Center | 571 E Beasley Rd, Ste A, Jackson, MS 39206-3042 | 2006-05-24 |
| 1174731590 | Matthews Florence Kirk | Social Worker | 571 E Beasley Rd, Suite -a, Jackson, MS 39206-3042 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813506 | Uma Mahesh Reddy Avula | Internal Medicine | 2500 N State St Rm L-504, Jackson, MS 39216-4500 | 2020-08-24 |
| 1649555467 | Cardiac Renal & Vascular Associates PC | Internal Medicine | 5240 Robinson Road Ext, Jackson, MS 39204-4276 | 2011-10-12 |
| 1821151598 | Kavita Luthra | Internal Medicine | 900 E Michigan Ave Ste 104, Jackson, MI 49201-2490 | 2006-12-18 |
| 1801971908 | Murphy S Martin | Internal Medicine | 1513 Lakeland Drive, Suite 200, Jackson, MS 39216 | 2006-10-26 |
| 1033124904 | Sybil F Raju | Internal Medicine | 1400 Woodrow Wilson Avenue, Va Hospital, Jackson, MS 39216 | 2006-07-29 |
| 1568489417 | Nosratollah Ghaemmaghami | Internal Medicine | 381 Medical Drive, Jackson, MS 39216 | 2006-07-16 |
| 1629007406 | Kent Alan Kirchner | Internal Medicine | 1500 E. Woodrow Wilson Blvd, Jackson, MS 39216-5199 | 2006-07-02 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1457844599 | Kidney & Hypertension Specialists of Jackson Piketon and Chillicothe L | Internal Medicine | 3 Acy Ave, Jackson, OH 45640-9561 | 2018-06-13 |
| 1104331511 | Aldo Torres | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2017-12-07 |
| 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.