RIDGEWOOD CLINICS PA (NPI# 1023233749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023233749 |
| Entity Type | Organization |
| Organization Name | RIDGEWOOD CLINICS PA |
| Practice Address |
1059 Ridgewood Clinic Jackson MS 39211 |
| Practice Telephone | 6019573211 |
| Practice Fax Number | 6019579753 |
| Mailing Telephone | 6019573211 |
| Mailing Fax Number | 6019579753 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2014-08-27 |
| Authorized Official Name | KRISHAN K. GUPTA (PHYSICIAN) |
| Authorized Official Telephone | 6019573211 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
12941 | MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09013996 | 05 |
| Street Address |
1059 RIDGEWOOD CLINIC |
| City | JACKSON |
| State | MS |
| Zip Code | 39211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677893 | Jackson Healing Clinic LLC | Counselor | 2020 Cascade Dr, Jackson, MI 49203-3810 | 2020-10-20 |
| 1568069524 | Philip Ray Nicholas | Counselor | 19 Wood Duck Cv, Jackson, TN 38305-6632 | 2020-10-02 |
| 1184242711 | New Life Goals, LLC | Counselor | 504 Cooper Rd, Jackson, MS 39212-4704 | 2020-07-09 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1962023812 | Kandace Ross | Counselor | 528 Woodbury Rd, Jackson, MS 39206-4830 | 2020-05-01 |
| 1629600945 | Modern Hope of Ms,llc | Counselor | 5825 Kings Pl, Jackson, MS 39211-3321 | 2020-02-05 |
| 1003447657 | Chandler & Associates, LLC | Counselor | 1900 Dunbarton Dr Ste G, Jackson, MS 39216-5015 | 2020-02-03 |
| 1659910701 | Laura E Rutledge | Counselor | 1437 Old Square Rd Ste 101, Jackson, MS 39211-5533 | 2020-01-06 |
| 1154960961 | Timothy A Norris | Counselor | 5026 Raintree Dr, Jackson, MS 39272-5753 | 2019-12-26 |
| 1982243838 | Paula Jane Blocker | Counselor | 401 West St Ste 117, Jackson, MN 56143-1219 | 2019-12-24 |
| Find all providers in JACKSON | ||||
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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.