Jackie E Mchenry Ii (NPI# 1649252057, PAC ID# 3971412743) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1649252057 |
| PAC ID by PECOS | 3971412743 |
| Professional Enrollment ID | I20070710000205 |
| Full Name | Jackie E Mchenry Ii |
| Organization Legal Name | OUTREACH HEALTH SERVICES,INC. |
| Address |
130 N High St Shubuta Medical Clinic Shubuta MS 39360-8870 |
| Phone Number | 6016871391 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1951386911 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 251316 | H C WATKINS MEMORIAL HOSPITAL INC |
| 251331 | BMH-CALHOUN |
| 250069 | RUSH FOUNDATION HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 140 Burke Calhoun City Rd, Calhoun City, MS 38916-9690 | 6626286611 | DOBBS EMERGENCY GROUP, LLC |
| 140 Burke Calhoun City Rd, Calhoun City, MS 38916-9690 | 662628661166239 | CORRECT CARE, INC. |
| 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 | 6016871391 | OUTREACH HEALTH SERVICES,INC. |
| Organization Legal Name | OUTREACH HEALTH SERVICES,INC. |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shuntay Mccormick | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| Shanika Boyd | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| Lakenya Forthner | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| Street Address |
130 N HIGH ST SHUBUTA MEDICAL CLINIC |
| City | SHUBUTA |
| State | MS |
| Zip | 39360-8870 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shuntay Mccormick | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| Shanika Boyd | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| Lakenya Forthner | Nurse Practitioner | Outreach Health Services,inc. | 130 N High St, Shubuta Medical Clinic, Shubuta, MS 39360-8870 |
| City | SHUBUTA |
| Zip Code | 39360 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SHUBUTA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jackie E Mchenry Ii.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.