COLBY PONDER (NPI# 1023572294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023572294 |
| Entity Type | Individual |
| Full Name | COLBY PONDER |
| Practice Address |
2434 S Eason Blvd Tupelo MS 38804-6942 |
| Practice Telephone | 6626404595 |
| Practice Fax Number | 6626806416 |
| Mailing Telephone | 6626404595 |
| Mailing Fax Number | 6626806416 |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2020-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
903137 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018203 | 05 |
| Street Address |
2434 S EASON BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-6942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508893074 | Ross E Collins Jr. | Psychiatry & Neurology | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2006-06-28 |
| 1245831551 | Lisa Roberts | Registered Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1295336519 | Kyra Neal | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1124635354 | Kecia Williams | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-10-01 |
| 1144837675 | Daniele Nolan | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1639786163 | Reagan Bartley | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1033725056 | Moesha Banks | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1891301719 | Makinley Neighbors | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1073129094 | Stephanie Johnson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1275149197 | Hallie Goodson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1710532668 | Sondra Bennett Pmhnp-bc LLC | Nurse Practitioner | 144 S Thomas St Ste 207, Tupelo, MS 38801-5337 | 2019-08-07 |
| 1891353413 | Jennifer Warren Pmhnp-bc LLC | Nurse Practitioner | 315 Magazine St Ste D, Tupelo, MS 38804-3974 | 2019-05-29 |
| 1548783509 | Ashley Cooper | Nurse Practitioner | 499 Gloster Creek Vlg Ste A-3, Tupelo, MS 38801-4600 | 2017-07-21 |
| 1356707400 | Jennifer K Warren | Nurse Practitioner | 315 Magazine St Ste C, Tupelo, MS 38804-4802 | 2016-01-05 |
| 1750416905 | Lisa Theresa Lippincott | Nurse Practitioner | 210 E Main St Ste D, Tupelo, MS 38804-4017 | 2007-02-21 |
| 1275182818 | Andrea Paige Pounds | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-09-06 |
| 1710532239 | Sabrina Hurd Hall | Nurse Practitioner | 1937 Briar Ridge Rd, Tupelo, MS 38804-5963 | 2019-08-02 |
| 1730656422 | Emily L Mccormac | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2018-10-31 |
| 1790138873 | Katherine E Ederer | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2016-07-13 |
| Find all providers in TUPELO | ||||
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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.