THE MANE PHYSICIAN (NPI# 1902435118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902435118 |
| Entity Type | Organization |
| Organization Name | THE MANE PHYSICIAN |
| Practice Address |
94 Spain Drive Grenada MS 38901 |
| Mailing Address |
428 Highway 6 E # 217 Batesville MS 38606-3000 |
| Practice Telephone | 7694874787 |
| Mailing Telephone | 6622625711 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| Authorized Official Name | MRS. CAMALA CHISM (OWNER) |
| Authorized Official Telephone | 7694874187 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 428 Highway 6 E # 217, Batesville, MS 386063000 | 7694874187 | 6622625711 |
| Street Address |
94 SPAIN DRIVE |
| City | GRENADA |
| State | MS |
| Zip Code | 38901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| 1841484490 | Viner Counseling Center | Community/Behavioral Health | 501 Southwest Frontage Rd, Grenada, MS 38901 | 2007-08-28 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010645 | The Royal Studio | Prosthetic/Orthotic Supplier | 246 Briarwood Dr Ste 102, Jackson, MS 39206-3027 | 2020-07-17 |
| 1881219046 | Color Me Jazzy | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-560, Ridgeland, MS 39157-4861 | 2020-06-13 |
| 1154945418 | Dream Hair Care | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste E, Hattiesburg, MS 39402-1006 | 2020-06-02 |
| 1578186409 | Perfectly Imperfect Wig Collection | Prosthetic/Orthotic Supplier | 418 Carrollton Ave, Lexington, MS 39095-3212 | 2020-05-27 |
| 1366064263 | Lavishinglux Hair Imports | Prosthetic/Orthotic Supplier | 200 Belle Chasse Cir, Jackson, MS 39212-3164 | 2020-05-13 |
| 1275155749 | Fearless Beauty Company | Prosthetic/Orthotic Supplier | 611 S Pear Orchard Rd # 771, Ridgeland, MS 39157-4836 | 2020-05-07 |
| 1982225850 | Luxury Locs | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste D, Hattiesburg, MS 39402-1006 | 2020-05-02 |
| 1518587914 | Bmb Medical Beautique | Prosthetic/Orthotic Supplier | 6515 Goodman Rd Ste 300, Olive Branch, MS 38654-7333 | 2020-04-26 |
| 1316567795 | Gyzele's Hair Boutique | Prosthetic/Orthotic Supplier | 1104 W Sunflower Rd, Cleveland, MS 38732-2440 | 2020-04-25 |
| 1083234462 | Shear Beauty 31 Hair Studio | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-573, Ridgeland, MS 39157-4861 | 2020-04-25 |
| Find all providers with the same taxonomy | ||||
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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.