MICHAEL JACEWICZ (NPI# 1427032150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427032150 |
| Entity Type | Individual |
| Full Name | MICHAEL JACEWICZ |
| Credential | MD |
| Practice Address |
1211 Union Ave Ste 200 Memphis TN 38104-6638 |
| Mailing Address |
6325 Humphreys Blvd Memphis TN 38120 |
| Practice Telephone | 9012595340 |
| Practice Fax Number | 9012595300 |
| Mailing Telephone | 9015227700 |
| Mailing Fax Number | 9015222600 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2008-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD22223 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3067379 | 05 |
| Street Address |
1211 UNION AVE STE 200 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-6638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689679912 | David Kenji Mcgregor | Pathology | 1211 Union Ave, Suite 300, Memphis, TN 38104-6638 | 2005-06-14 |
| 1487008850 | Charles Theodore Fryberger IIi | Student in an Organized Health Care Education/Training Program | 1211 Union Ave, Suite 510, Memphis, TN 38104-6638 | 2016-04-21 |
| 1639537830 | Vanessa L Armenise | Nurse Practitioner | 1211 Union Ave, Suite 300, Memphis, TN 38104-6638 | 2016-02-02 |
| 1659745420 | West Clinic, P.C. | Internal Medicine | 1211 Union Ave, Memphis, TN 38104-6638 | 2015-11-17 |
| 1033595731 | Memphis Pathology Group PC | Pathology | 1211 Union Ave, Suite 875, Memphis, TN 38104-6638 | 2015-08-04 |
| 1922416361 | Aaron Greear | Physical Therapist | 1211 Union Ave, Suite 195, Memphis, TN 38104-6638 | 2014-07-29 |
| 1104234509 | Matthew Peterson | Physical Therapist | 1211 Union Ave, Suite 195, Memphis, TN 38104-6638 | 2014-07-29 |
| 1851709281 | Pritha Mony | Physical Therapist | 1211 Union Ave, Suite 195, Memphis, TN 38104-6638 | 2014-07-29 |
| 1497163257 | Melinda Laughter Carden | Physical Therapist | 1211 Union Ave, Ste 195, Memphis, TN 38104-6638 | 2014-07-24 |
| 1083045553 | Jacquelyn Mcdonald | Physical Therapist | 1211 Union Ave, Suite 195, Memphis, TN 38104-6638 | 2013-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861873846 | Rashi Krishnan | Psychiatry & Neurology | 1265 Union Avenue Dept of Neurology, Memphis, TN 38104 | 2015-06-15 |
| 1164841326 | Beth Anne Cavanaugh | Psychiatry & Neurology | 848 Adams Ave Ste 400l, Memphis, TN 38103-2816 | 2014-04-15 |
| 1417108796 | London Corporaton | Psychiatry & Neurology | 23 South Pauline Street, Suite 709, Memphis, TN 38104-3121 | 2008-10-06 |
| 1740459817 | Adrain B. Blotner Md PC | Psychiatry & Neurology | 6401 Poplar Ave Ste 316, Memphis, TN 38119-4806 | 2008-02-22 |
| 1003005885 | James H Jaster | Psychiatry & Neurology | 23 South Pauline Street, Suite 709, Memphis, TN 38104-3121 | 2007-10-17 |
| 1164634978 | Monisha Dutta | Psychiatry & Neurology | 880 Madison Avenue, Memphis, TN 38103-3409 | 2007-05-04 |
| 1891911954 | Rada Petrinjac-nenadic | Psychiatry & Neurology | 5100 Sanderlin Ave, Suite 2100, Memphis, TN 38117-4387 | 2007-04-17 |
| 1306994611 | Charles Hughes Hubbert | Psychiatry & Neurology | Memphis Va Hospital, Dept. Neurology, 1030 Jefferson Avenue, Memphis, TN 38104 | 2007-01-05 |
| 1881775799 | Butler Neurology PC | Psychiatry & Neurology | 1264 Wesley Drive, Suite 209, Memphis, TN 38116 | 2006-10-18 |
| 1477660306 | Marc David Malkoff | Psychiatry & Neurology | 855 Monroe Ave, Suite 415 Link Building, Memphis, TN 38103-4901 | 2006-08-24 |
| Find all providers in MEMPHIS | ||||
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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.