JACKSON REGIONAL WOMENS CENTER (NPI# 1235155276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235155276 |
| Entity Type | Organization |
| Organization Name | JACKSON REGIONAL WOMENS CENTER |
| Practice Address |
72 Physicians Dr Jackson TN 38305-2070 |
| Practice Telephone | 7316684455 |
| Practice Fax Number | 7316689007 |
| Mailing Telephone | 7316684455 |
| Mailing Fax Number | 7316689007 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BRENDA J HOWELL (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7316684455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3706927 | 05 |
| Street Address |
72 PHYSICIANS DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-2070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427026137 | Keith A Micetich | Specialist | 72 Physicians Dr, Jackson, TN 38305-2070 | 2006-03-09 |
| 1265966634 | Tayler M Johnston | Nurse Practitioner | 72 Physicians Dr, Jackson, TN 38305 | 2017-04-12 |
| 1114346673 | Rachel Holmes | Nurse Practitioner | 72 Physicians Dr, Jackson, TN 38305-2070 | 2014-04-14 |
| 1376511097 | Sandra J Boxell | Specialist | 72 Physicians Dr, Jackson, TN 38305-2070 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528477007 | Shandeidra Nicole Bonds-singleton | Obstetrics & Gynecology | 657 Skyline Dr Dept Of, Jackson, TN 38301-3903 | 2014-08-08 |
| 1477995454 | Camille Stephanie Mellijor-figg | Obstetrics & Gynecology | 430 S Cache St, Jackson, WY 83001-8692 | 2013-07-19 |
| 1245535392 | River Oaks Management Company, LLC | Obstetrics & Gynecology | 1860 Hospital Dr, Suite 103, Jackson, MS 39204-3410 | 2011-01-21 |
| 1134374291 | Joy Luck | Obstetrics & Gynecology | 2009 W Michigan Ave, Jackson, MI 49202-4010 | 2008-11-17 |
| 1720241532 | Henry Earl West | Obstetrics & Gynecology | 657 Skyline Dr Ste B, Jackson, TN 38301-3903 | 2008-07-02 |
| 1649432626 | William Ashley Hood D.o. | Obstetrics & Gynecology | 1020 River Oaks Dr Ste 430, Jackson, MS 39232-9500 | 2008-06-30 |
| 1790956837 | Jackson Ob-gyn Plc | Obstetrics & Gynecology | 306 W Washington, Ste 102, Jackson, MI 49201 | 2008-03-17 |
| 1295863611 | Richard Nmi Ignatius | Obstetrics & Gynecology | 23 Conor Rd, Jackson, NJ 08527-3781 | 2007-02-28 |
| 1902941768 | Jackson Healthcare for Women Pa | Obstetrics & Gynecology | 1047 N Flowood Dr, Jackson, MS 39232-9533 | 2007-02-20 |
| 1689747396 | Shore Point Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 22 Linda Dr, Jackson, NJ 08527-5026 | 2006-11-17 |
| 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.