EASTGATE PEDS CARE (NPI# 1063557163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063557163 |
| Entity Type | Organization |
| Organization Name | EASTGATE PEDS CARE |
| Practice Address |
2203 Highway 39 N Ste B Meridian MS 39301-2609 |
| Practice Telephone | 6014845955 |
| Practice Fax Number | 6014845960 |
| Mailing Telephone | 6014845955 |
| Mailing Fax Number | 6014845960 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BEATRICE O. NEWELL (PHYSICIAN) |
| Authorized Official Telephone | 6014845955 |
| Authorized Official Credential | MD FAAP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07825736 | 05 |
| Street Address |
2203 HIGHWAY 39 N STE B |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801216940 | Seth Branahl | Pediatrics | 520 S Eagle Rd Ste 2209, Meridian, ID 83642-6354 | 2014-04-16 |
| 1972872950 | John Dubard Mceachin | Pediatrics | 4820 Country Club Dr, Meridian, MS 39305-1839 | 2011-12-21 |
| 1841598273 | Anderson Physician Alliance, Inc. | Pediatrics | 2514 67th Avenue Loop Ste 112, Meridian, MS 39307-7260 | 2011-03-09 |
| 1033435896 | Lisa S Labor | Pediatrics | 1620 S. Celebration, Meridian, ID 83642 | 2010-04-19 |
| 1770729063 | Alliance Medical Group, LLC | Pediatrics | 3280 E. Lanark Drive, Meridian, ID 83642 | 2008-12-17 |
| 1356504872 | Robert Ira Eubanks | Pediatrics | 1523 22nd Ave Ste B, Meridian, MS 39301-4016 | 2008-07-03 |
| 1154535375 | Mary Alice Schaefer | Pediatrics | 7961 Van Zyverden Rd, Meridian, MS 39305-9124 | 2007-05-09 |
| 1477501880 | Elsa J. Lee | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-05-05 |
| 1356306740 | Kimberly D Ferguison | Pediatrics | 3277 E Louise Dr Ste 200, Meridian, ID 83642-9351 | 2006-04-19 |
| 1093797623 | Lara L. Ross | Pediatrics | 1500 Hwy 19 N, Meridian, MS 39307-5335 | 2005-11-18 |
| Find all providers in MERIDIAN | ||||
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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.