JACOB KRIEDERMANN (NPI# 1144614603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144614603 |
| Entity Type | Individual |
| Full Name | JACOB KRIEDERMANN |
| Credential | D.O. |
| Practice Address |
877 Jefferson Ave Memphis TN 38103-2807 |
| Mailing Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 9015457100 |
| Mailing Telephone | 6019845582 |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 3425 | TN | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | T-2975 | MS | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01150325 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 N State St, Jackson, MS 392164500 | 6019845582 |
| Street Address |
877 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103-2807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144225590 | Clare L Mccarthy | Emergency Medicine | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2005-06-14 |
| 1508466467 | Ryain Alexander | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-10-29 |
| 1366049132 | Shruti Elizabeth Anthony | Anesthesiology | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-10-05 |
| 1750998464 | Matthew Porch | Radiologic Technologist | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-26 |
| 1851906101 | Stephanie Marie Baggett | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-14 |
| 1275148561 | Suzanne D Moyer | Nurse Practitioner | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-09-13 |
| 1760094999 | Adriann Skeen | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-08-19 |
| 1578181434 | Erika Gruber | Pharmacist | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-07-08 |
| 1740800267 | Katara Evonne Jackson | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-04-24 |
| 1891315560 | Emily Ann West | Dietitian, Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891287090 | Shelby Linwood Gillette Jr. | Emergency Medicine | 170 S Goodlett St Ste A, Memphis, TN 38117-2914 | 2018-06-04 |
| 1710413885 | Michael Sidney Reich | Emergency Medicine | 665 Tennessee St, Memphis, TN 38103-8794 | 2017-05-10 |
| 1871049023 | Keystone Medical Services of West Point Inc | Emergency Medicine | 6075 Poplar Avenue, Suite 401, Memphis, TN 38119-0114 | 2016-08-28 |
| 1740634054 | Thomas Oswald | Emergency Medicine | 251 S Claybrook St Ste A206, Memphis, TN 38104-3539 | 2016-04-22 |
| 1134573777 | Amanda Box | Emergency Medicine | 251 S Claybrook St Ste A-206, Memphis, TN 38104-3539 | 2016-04-20 |
| 1265811590 | Elizabeth Coombs Gamble | Emergency Medicine | 50 N Dunlap St # 20, Memphis, TN 38103 | 2015-05-19 |
| 1154716306 | Kimberly Michelle Brown | Emergency Medicine | 104 Sawyer Cir Apt 494, Memphis, TN 38103 | 2015-04-04 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1528472289 | Diego S Espinoza | Emergency Medicine | 4095 American Way Ste 1, Memphis, TN 38118-8339 | 2014-06-19 |
| 1881037554 | Cailin Mckenna Frank | Emergency Medicine | 51 N Dunlap St, Ste 100, Lebonheur Children's Hospital - Er, Memphis, TN 38103 | 2013-04-12 |
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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.