Patrise Bennett (NPI# 1407878747, PAC ID# 6507045002) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1407878747 |
| PAC ID by PECOS | 6507045002 |
| Professional Enrollment ID | I20110131000498 |
| Full Name | Patrise Bennett |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Address |
1777 Ellis Ave Jackson MS 39204-3616 |
| Phone Number | 6013710400 |
| Gender | F |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0941583728 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1777 Ellis Ave, Jackson, MS 39204-3616 | 6013710400 | MEA PRIMARY CARE PLUS, LLC |
| 5606 Old Canton Rd, Jackson, MS 39211-4217 | 6019573333 | MEA PRIMARY CARE PLUS, LLC |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Moumita Do Biswas | Family Medicine | Mea Primary Care Plus, LLC | 106 Lake Vista Pl, Brandon, MS 39047-6384 |
| Heather Haynes Walker | Nurse Practitioner | Mea Primary Care Plus, LLC | 323 Hwy 51, Ridgeland, MS 39157-3428 |
| Brennan F Vaughn | Physician Assistant | Mea Primary Care Plus, LLC | 4204 Clay St, Vicksburg, MS 39183-3438 |
| Bethany Sumerford | Nurse Practitioner | Mea Primary Care Plus, LLC | 498 Hwy 80 E, Mea Primary Care Plu, Clinton, MS 39056-4720 |
| Tyler Ladner | Physician Assistant | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Michael L Brasel | Physician Assistant | Mea Primary Care Plus, LLC | 935 Hwy 51, Madison, MS 39110-8407 |
| Diana Lynn Entrekin | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| John Brooks | Emergency Medicine | Mea Primary Care Plus, LLC | 342 Gilchrist Dr, Pearl, MS 39208-6671 |
| Robert L Russell | Family Medicine | Mea Primary Care Plus, LLC | 1515 Jefferson St, Laurel, MS 39440-4244 |
| Carole Lynne Singleton | Nurse Practitioner | Mea Primary Care Plus, LLC | 307 E Fifteenth St, Yazoo City, MS 39194-2631 |
| Street Address |
1777 ELLIS AVE |
| City | JACKSON |
| State | MS |
| Zip | 39204-3616 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sylvia Martin | Family Medicine | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Kristin Monsour Cowan | Nurse Practitioner | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Craig N Howard | Physical Therapy | Gptrs II | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Racolesha R Denson | Nurse Practitioner | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| William Eugene Loper | Family Medicine | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edith F Smith Rayford | Obstetrics/gynecology | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Robert Smith | Family Medicine | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Tamara C Winfield | Family Medicine | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Edgar Miller | Nurse Practitioner | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Eurekia D Samuel | Nurse Practitioner | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Obie M Mcnair | Internal Medicine | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Myra A Wheaton | Family Medicine | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Denetta D Ross | Nurse Practitioner | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Ruth A Walker | Clinical Social Worker | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Marcia J Hays | Registered Dietitian Or Nutrition Professional | Central Mississippi Health Services, Inc. | 5429 Robinson Rd Ext, Jackson, MS 39204 |
| Find all physicians in zip 39204 | |||
| City | JACKSON |
| Zip Code | 39204 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | JACKSON + FAMILY MEDICINE |
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| 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.