PERSONALIZED WELLNESS (NPI# 1942740188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942740188 |
| Entity Type | Organization |
| Organization Name | PERSONALIZED WELLNESS |
| Practice Address |
573 Highway 51 Ste D Ridgeland MS 39157-2605 |
| Practice Telephone | 6019551804 |
| Mailing Telephone | 6019551804 |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | DONALD R BONNER (OWNER) |
| Authorized Official Telephone | 6019551804 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 13234 | MS | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | PERSONALIZED WELLNESS, LLC | 150 Mountain Ave, Bloomfield, CT 06002 |
| New York State Corporations | PERSONALIZED WELLNESS, LLC | 90 State Street, Suite 700, Office 40, Albany, New York 12207 |
| Washington State Corporations | PERSONALIZED WELLNESS, LLC | 1505 Nw Gilman Blvd #3, Issaquah, WA 98027 |
| Street Address |
573 HIGHWAY 51 STE D |
| City | RIDGELAND |
| State | MS |
| Zip Code | 39157-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1225680945 | Verthena Edwards | Home Health | 301 Pinehurst Cir, N/a, Ridgeland, MS 39157 | 2019-07-12 |
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1841786365 | Whitney Paige Crum | Speech-Language Pathologist | Laskin Therapy Group Pa, 207 W Jackson St, Ridgeland, MS 39157 | 2018-07-09 |
| 1811487002 | Camille Brockett | Social Worker | 270 Trace Colony Park Dr Ste B, Ridgeland, MS 39157 | 2018-05-14 |
| 1588171177 | Layson Counseling Group, Pllc | Counselor | 573 Hwy 51 Suite B, Ridgeland, MS 39157 | 2018-01-04 |
| 1407376452 | Mobility Rehab LLC | Clinic/Center | 745 S Pear Orchard Road, Apt 335, Ridgeland, MS 39157 | 2017-06-21 |
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1851755714 | Jerlunda Lynn Dudley | Social Worker | 511 Clark Street, Rosedale, MS 39157 | 2016-04-07 |
| Find all providers in zip 39157 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1366531162 | Tricia L Etheridge | General Practice | 109 S Green St, Ridgeland, SC 29936-9165 | 2006-10-12 |
| 1821589318 | Trustcare Clinics, LLC | General Practice | 361 Township Ave Ste 200, Ridgeland, MS 39157 | 2018-05-21 |
| 1891748463 | Chatchaval Vuthiganon | General Practice | 1506 Grays Highway, Suite C, Ridgeland, SC 29936 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487260329 | Good Shepard LLC | General Practice | 632 Lakeland East Dr, Flowood, MS 39232-9565 | 2020-09-16 |
| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1780241729 | Southeast Reginald Solutions,pllc | General Practice | 310 River Forest Ln, Brandon, MS 39047-7020 | 2019-05-24 |
| 1235601907 | William Carey University | General Practice | 710 William Carey Pkwy, Hattiesburg, MS 39401-7842 | 2018-12-19 |
| 1770050908 | Thompson Medical Service, LLC | General Practice | 1200 Hwy 15 North, Blue Mountain, MS 38610 | 2018-10-25 |
| 1790265932 | Antonio Reyes Del Castillo Jr. | General Practice | 590 Parchman Road 12, Parchman, MS 38738-3001 | 2018-08-16 |
| 1700397239 | Marysol Camejo Romero | General Practice | 728 Benwick Dr, Brandon, MS 39047-8111 | 2017-10-24 |
| 1013431519 | Madena Jane Gibson | General Practice | 1695 Moses Rd, Raymond, MS 39154-8766 | 2017-07-27 |
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| 1184080855 | Racquel Simone Allen | General Practice | 5301 Bainbridge Ave # 58, Gulfport, MS 39501-9041 | 2016-01-11 |
| 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.