BAPTIST JACKSON HEART CARDIOLOGY CLINIC-KOSCIUSKO (NPI# 1013280494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013280494 |
| Entity Type | Organization |
| Organization Name | BAPTIST JACKSON HEART CARDIOLOGY CLINIC-KOSCIUSKO |
| Practice Address |
1600 N State St Suite 400 Jackson MS 39202-1689 |
| Practice Telephone | 6019827850 |
| Practice Fax Number | 6019449780 |
| Mailing Telephone | 6019827850 |
| Mailing Fax Number | 6019449780 |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | ELIZABETH MULLINS (PRESIDENT-MBHS) |
| Authorized Official Telephone | 6012924261 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Street Address |
1600 N STATE ST SUITE 400 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003830563 | Robert Adams | Psychologist | 1600 N State St, Ste 400, Jackson, MS 39202-1689 | 2006-07-27 |
| 1417334178 | Medical Foundation of Central Ms Inc. | Obstetrics & Gynecology | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2015-05-01 |
| 1821475617 | Medical Foundation of Central Ms, Inc | Psychiatry & Neurology | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2015-04-30 |
| 1730511064 | Joseph Shannon Davis | Nurse Anesthetist, Certified Registered | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2013-08-09 |
| 1598014045 | Sara Harbaugh Mcgrath | Counselor | 1600 N State St, Suite 100, Jackson, MS 39202-1689 | 2012-08-30 |
| 1831462217 | Baptist Jackson Heart Cardiology Clinic-yazoo City | Internal Medicine | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2012-02-16 |
| 1902178346 | Baptist Jackson Heart Cardiology Clinic-magee | Internal Medicine | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2012-02-01 |
| 1457649873 | Continuumrx, Inc. | Durable Medical Equipment & Medical Supplies | 1600 N State St, Suite 102, Jackson, MS 39202-1689 | 2011-07-19 |
| 1194059964 | Lacy M Deese, LLC | Counselor | 1600 N State St, Suite 100, Jackson, MS 39202-1689 | 2009-09-28 |
| 1295963742 | Murphy S. Martin, M.d., Pllc | Internal Medicine | 1600 N State St, Suite 110, Jackson, MS 39202-1689 | 2009-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1912143991 | Theophilus James Humphreys | Internal Medicine | 164 W University Pkwy Ste A, Jackson, TN 38305-1621 | 2008-12-23 |
| 1548423114 | Olurotimi Badero | Internal Medicine | 5240 Robinson Rd, Jackson, MS 39204-4134 | 2008-07-03 |
| 1740480961 | Cardiovascular Clinic of West Tn PC | Internal Medicine | 2968 North Highland Avenue, Jackson, TN 38305-3609 | 2007-07-25 |
| 1013112457 | The Cardiovascular Clinic of West Tennessee,p.c. | Internal Medicine | 162 Murray Guard Dr, Suite A, Jackson, TN 38305-3609 | 2007-06-17 |
| 1497829550 | Shawn A Baldwin | Internal Medicine | 27a Medical Center Dr, Jackson, TN 38301-3949 | 2006-11-20 |
| 1083715254 | Kenny K. Charn | Internal Medicine | 201 Clinton Rd, Suite 105, Jackson, CA 95642-2648 | 2006-09-26 |
| 1861590457 | Sandra Speckels Mccearley | Internal Medicine | 970 Lakeland Dr Ste 61, Jackson, MS 39216 | 2006-09-20 |
| 1063425734 | Mabbu Jayakumar | Internal Medicine | 168 W University Pkwy Ste C, Jackson, TN 38305-1624 | 2006-08-14 |
| 1851305429 | Jackson Cardiology Associates, P.a. | Internal Medicine | 971 Lakeland Dr Ste 850, Jackson, MS 39216-4608 | 2006-07-28 |
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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.