BENJAMIN C. MCINTYRE (NPI# 1407067705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407067705 |
| Entity Type | Individual |
| Full Name | BENJAMIN C. MCINTYRE |
| Credential | M.D. |
| Practice Address |
2500 N State St Dept of Surgery Jackson MS 39216-4500 |
| Practice Telephone | 6019845452 |
| Practice Fax Number | 6018153322 |
| Mailing Telephone | 6019845452 |
| Mailing Fax Number | 6018153322 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2016-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 32525 | SC | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 32525 | SC | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 57007052 | OH | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
32525 | SC | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
24236 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 189604 | 05 | |
| MS | 00173530 | 05 | |
| SC | MEDICARE PTAN | AA74671955 | 01 |
| MS | RR MEDICARE PTAN | P01702551 | 01 |
| SC | 325259 | 05 |
| Street Address |
2500 N STATE ST DEPT OF SURGERY |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| 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 | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164484796 | Pramit S Malhotra | Surgery | 900 E Michigan Ave, Ste 108, Jackson, MI 49201-2457 | 2006-04-06 |
| 1043872948 | John Magruder Sullivan IIi | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2019-07-01 |
| 1508352196 | Katherine Christine Benedict | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2018-07-06 |
| 1780121970 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N. East Ave, Jackson, MI 49201 | 2017-01-25 |
| 1437386232 | Emily T Wolfe | Surgery | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-06-18 |
| 1598979064 | Peter B Arnold | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2007-05-10 |
| 1316071145 | John C Payne | Surgery | 555 E Broadway, Suite 211, Jackson, WY 83001 | 2007-03-15 |
| 1063549178 | Plastic Surgery Center, P.a. | Surgery | 1920 Chadwick Dr, Suite 108, Jackson, MS 39204-3471 | 2007-02-27 |
| 1538244579 | John Barry Mccraw | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2006-10-26 |
| 1073695706 | William C Lineaweaver | Surgery | 1850 Chadwick Dr Ste 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2006-10-20 |
| 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.