TIMOTHY P KERUT (NPI# 1932130127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932130127 |
| Entity Type | Individual |
| Full Name | TIMOTHY P KERUT |
| Credential | MD |
| Practice Address |
2200 Highway 61 N Vicksburg MS 39183-8246 |
| Mailing Address |
104 Mcauley Dr Vicksburg MS 39183-2825 |
| Practice Telephone | 6018833320 |
| Mailing Telephone | 6016387271 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 11047 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00120441 | 05 | |
| MS | AETNA | 5694020 | 01 |
| LA | 1546143 | 05 |
| Street Address |
2200 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801827019 | John David Fagan | Urology | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1023478435 | La Miss Diabetic Shoes | Durable Medical Equipment & Medical Supplies | 2200 Highway 61 N, Suite 3400, Vicksburg, MS 39183-8246 | 2016-02-26 |
| 1154789717 | Carrie Eure | Physician Assistant | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2016-02-10 |
| 1861622268 | Vicksburg Clinic LLC | Clinic/Center | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2009-07-20 |
| 1356593875 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2008-10-15 |
| 1326079518 | Alfred G Windham | Otolaryngology | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1750312963 | Gloria J Butler | Family Medicine | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| 1811928005 | Thomas K Sligh | Internal Medicine | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619140399 | Vicksburg Allergy and Asthma | Allergy & Immunology | 104 Mcauley Dr, Vicksburg, MS 39183-2825 | 2008-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780948216 | Blake Olmsted | Allergy & Immunology | 6414 U S Highway 98 Ste 80, Hattiesburg, MS 39402-7838 | 2012-06-29 |
| 1689803918 | Patricia Honea Stewart | Allergy & Immunology | 878 Lakeland Dr., Lb-building, Jackson, MS 39216-4500 | 2009-07-08 |
| 1801094016 | Mississippi Asthma and Allergy Clinic Pa | Allergy & Immunology | 680d Hwy 51 North, Ridgeland, MS 39157 | 2007-07-10 |
| 1154529709 | Chelle P Wilhelm | Allergy & Immunology | 1513 Lakeland Dr Ste 101, Jackson, MS 39216-4829 | 2007-07-05 |
| 1841491404 | Delta Asthma & Allergy | Allergy & Immunology | 2335 Highway 1 S, Greenville, MS 38701-8337 | 2007-05-30 |
| 1114134863 | Karen Ashmore Maltby | Allergy & Immunology | 811 Garfield St, Tupelo, MS 38801-5748 | 2007-05-16 |
| 1407955537 | Joshua F Phillips | Allergy & Immunology | 1513 Lakeland Dr., Suite 101, Jackson, MS 39216 | 2006-09-22 |
| 1720007040 | Charlene Bell Broome | Allergy & Immunology | 6414 U S Highway 98, Ste 80, Hattiesburg, MS 39402-7815 | 2006-07-18 |
| 1902882251 | Mississippi Asthma & Allergy Clinic Pa | Allergy & Immunology | 1513 Lakeland Dr, Ste 100, Jackson, MS 39216-4829 | 2005-12-19 |
| 1003892357 | Daniel L Venarske | Allergy & Immunology | 1513 Lakeland Dr., Suite 101, Jackson, MS 39216 | 2005-12-19 |
| 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.