SUDHEER TANGELLA (NPI# 1124382536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124382536 |
| Entity Type | Individual |
| Full Name | SUDHEER TANGELLA |
| Credential | MD |
| Practice Address |
878 Lakeland Dr Jackson MS 39216-4644 |
| Mailing Address |
Po Box 4999 Jackson MS 39296-4999 |
| Practice Telephone | 6019846800 |
| Practice Fax Number | 6019846811 |
| Mailing Telephone | 6019845426 |
| Mailing Fax Number | 6019846889 |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2012-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 836-L | MS | Allopathic & Osteopathic Physicians |
| Street Address |
878 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841284478 | Janet L. Ricks | Family Medicine | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2005-09-09 |
| 1215593082 | Khusbuben Shantilal Patel | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2019-05-16 |
| 1073179842 | Oluwasegun Omoyemi Lijofi | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2019-05-16 |
| 1972168870 | Kaneisha Monique Thompson | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2019-05-06 |
| 1700441920 | Arame Motazedi | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2019-05-02 |
| 1487218806 | Karishmaben Sureshkumar Amin | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2019-05-01 |
| 1780174284 | Maria Syed Abid Hussain | Student in an Organized Health Care Education/Training Program | 878 Lakeland Dr, Jackson, MS 39216 | 2018-05-10 |
| 1881958288 | Shannon J. Myers | Family Medicine | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2012-06-29 |
| 1194089508 | Ajay Vongala | Family Medicine | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2012-06-29 |
| 1629365358 | Joanna Diane Bayles | Family Medicine | 878 Lakeland Dr, Jackson, MS 39216-4644 | 2011-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1003470758 | Central Mississippi Health Services, Inc | Family Medicine | 3450 Highway 80 W Ste 71, Jackson, MS 39209-7201 | 2019-04-29 |
| 1922515493 | Meaghan Schenk Johnson | Family Medicine | 2969 Curran Dr N # 200, Jackson, MS 39216-4121 | 2018-01-05 |
| 1740795731 | Emily Colleen Dunaway | Family Medicine | 1227 N State St # 101, Jackson, MS 39202-2002 | 2017-12-12 |
| 1679086367 | Hope Np House Call Practice | Family Medicine | 98 Grandview Ave, Jackson, OH 45640-9090 | 2017-11-16 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1891235289 | Logan Hardin | Family Medicine | 1270 Union University Dr Ste A, Jackson, TN 38305-3856 | 2017-03-03 |
| 1255782843 | Seth Tyler Koehler | Family Medicine | 2600 E Main St, Jackson, MO 63755-2473 | 2016-06-25 |
| 1720495245 | Gopi Patel | Family Medicine | 27 S Cooks Bridge Rd Ste 2-1, Jackson, NJ 08527-2524 | 2014-07-16 |
| 1154735165 | Lk Physicians Services Pllc | Family Medicine | 36 Lake Pointe Dr, Jackson, TN 38305-8113 | 2014-06-17 |
| 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.