MAGNOLIA WOMAN'S CLINIC, P.A. (NPI# 1144491580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144491580 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA WOMAN'S CLINIC, P.A. |
| Practice Address |
970 Lakeland Dr Suite 43 Jackson MS 39216-4635 |
| Practice Telephone | 6012008201 |
| Mailing Telephone | 6012008201 |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-03-13 |
| Authorized Official Name | WALTER RAY WOLFE (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6012008201 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
11096 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | BLUE CROSS BLUE SHEILD | 428940305A | 01 |
| MS | 00131201 | 05 | |
| AETNA | 4224712 | 01 | |
| MS | UNITED HEALTH CARE | 7430106 | 01 |
| Street Address |
970 LAKELAND DR SUITE 43 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255303517 | St Dominic Ambulatory Surgery Center L L C | Clinic/Center | 970 Lakeland Dr, Suite 15, Jackson, MS 39216-4601 | 2006-02-02 |
| 1326689662 | Jessica M Tolar | Nurse Practitioner | 970 Lakeland Dr, Jackson, MS 39216-4635 | 2019-10-07 |
| 1861810889 | Radiation Oncology Associates of Mississippi | Radiology | 970 Lakeland Dr, Suite 34, Jackson, MS 39216-4635 | 2014-04-07 |
| 1124452859 | St Dominic Medical Associates LLC | Pain Medicine | 970 Lakeland Dr, Suite 45, Jackson, MS 39216-4635 | 2013-08-29 |
| 1780988949 | Holly M Bridges | Nurse Practitioner | 970 Lakeland Dr, Suite 61, Jackson, MS 39216-4635 | 2011-01-03 |
| 1023249497 | Lynn Ann Vincent | Nurse Practitioner | 970 Lakeland Dr, Suite 61, Jackson, MS 39216-4635 | 2009-08-04 |
| 1578793220 | Valerie C Bailey | Nurse Practitioner | 970 Lakeland Dr, Jackson, MS 39216-4635 | 2009-07-15 |
| 1174757017 | St Dominic Medical Associates LLC | Otolaryngology | 970 Lakeland Dr, Suite 40, Jackson, MS 39216-4635 | 2009-05-06 |
| 1578720231 | Angela Sterling | Nurse Practitioner | 970 Lakeland Dr, Suite 61, Jackson, MS 39216-4635 | 2008-05-20 |
| 1811198005 | Philip Lamar Chustz | Internal Medicine | 970 Lakeland Dr, Suite 61, Jackson, MS 39216-4635 | 2007-05-29 |
| 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 | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1063618171 | Kevin L Galloway, Do Pllc | Obstetrics & Gynecology | 1860 Chadwick Dr, 300, Jackson, MS 39204-3463 | 2007-06-25 |
| 1316143431 | Paul Rice, Md Pllc | Obstetrics & Gynecology | 1860 Chadwick Dr, 300, Jackson, MS 39204-3463 | 2007-06-25 |
| 1174744379 | Southern Women's Health, Pllc | Obstetrics & Gynecology | 1020 River Oaks Dr, Suite 310, Jackson, MS 39232-9512 | 2007-05-02 |
| 1053486571 | Lori J. Fulton, M.d. | Obstetrics & Gynecology | 1963 W Mcdowell Rd, Jackson, MS 39204-4217 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558445981 | Womens Wellness Institute Pllc | Obstetrics & Gynecology | 2401 16th Street, Meridian, MS 39301-2123 | 2006-10-24 |
| 1891155867 | Brittney Joelle Brown | Obstetrics & Gynecology | 421 S 28th Ave Ste 200, Hattiesburg, MS 39401-7208 | 2016-03-03 |
| 1235598624 | Medical Foundation, Inc. | Obstetrics & Gynecology | 2401 16th St, Meridian, MS 39301-3950 | 2016-02-15 |
| 1265865885 | Joseph Robert Harmon | Obstetrics & Gynecology | 3714 Highway 72 W, Corinth, MS 38834 | 2013-08-19 |
| 1851731277 | Chad Edward Cooley | Obstetrics & Gynecology | 291 E Layfair Dr, Flowood, MS 39232-9527 | 2013-06-29 |
| 1508200395 | Sara Campbell | Obstetrics & Gynecology | 117 Fairfield Dr, New Albany, MS 38652-3107 | 2013-04-23 |
| 1326389651 | Ob-gyn Group of Hattiesburg, LLC | Obstetrics & Gynecology | 105 Asbury Cir, Suite A-2, Hattiesburg, MS 39402-1397 | 2013-03-12 |
| 1851657803 | Rush Medical Group of Newton, Pa | Obstetrics & Gynecology | 1106 Central Dr, Suite 3, Philadelphia, MS 39350-8972 | 2012-04-04 |
| 1144409822 | Natchez Regional Clinic | Obstetrics & Gynecology | 136 Jefferson Davis Blvd, Suite B, Natchez, MS 39120-5104 | 2007-10-30 |
| 1083827315 | Delta Obstetrics & Gynecology, P.a. | Obstetrics & Gynecology | 801 1st St, Cleveland, MS 38732-2309 | 2007-05-07 |
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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.