CHRISTINA RENEE IVY (NPI# 1457506073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457506073 |
| Entity Type | Individual |
| Full Name | CHRISTINA RENEE IVY |
| Practice Address |
1166 Greenway Dr Suite B5 Jackson MO 63755-2913 |
| Mailing Address |
1166 Greenway Drive Suite B5 Jackson MO 63755 |
| Practice Telephone | 5732439900 |
| Practice Fax Number | 5732435320 |
| Mailing Telephone | 5732439900 |
| Mailing Fax Number | 5732435320 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
2008009204 | MO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394899 | Christina Marie Ivy | Nurse Practitioner | 2765 Red Cedar Parc Dr S, O Fallon, MO 63368-6609 | 2018-11-12 |
| Street Address |
1166 GREENWAY DR SUITE B5 |
| City | JACKSON |
| State | MO |
| Zip Code | 63755-2913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326200056 | Gold Leaf Enterprises Inc | Case Manager/Care Coordinator | 1166 Greenway Dr, Suite B5, Jackson, MO 63755-2913 | 2008-06-25 |
| 1134110836 | Wayne A Sarno | Podiatrist | 1166 Greenway Dr, Suite B2, Jackson, MO 63755-2913 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1215438585 | The Villas of Jackson LLC | Assisted Living Facility | 670 Broadridge, Jackson, MO 63755 | 2018-02-22 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| Find all providers in zip 63755 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677893 | Jackson Healing Clinic LLC | Counselor | 2020 Cascade Dr, Jackson, MI 49203-3810 | 2020-10-20 |
| 1568069524 | Philip Ray Nicholas | Counselor | 19 Wood Duck Cv, Jackson, TN 38305-6632 | 2020-10-02 |
| 1184242711 | New Life Goals, LLC | Counselor | 504 Cooper Rd, Jackson, MS 39212-4704 | 2020-07-09 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1962023812 | Kandace Ross | Counselor | 528 Woodbury Rd, Jackson, MS 39206-4830 | 2020-05-01 |
| 1629600945 | Modern Hope of Ms,llc | Counselor | 5825 Kings Pl, Jackson, MS 39211-3321 | 2020-02-05 |
| 1003447657 | Chandler & Associates, LLC | Counselor | 1900 Dunbarton Dr Ste G, Jackson, MS 39216-5015 | 2020-02-03 |
| 1659910701 | Laura E Rutledge | Counselor | 1437 Old Square Rd Ste 101, Jackson, MS 39211-5533 | 2020-01-06 |
| 1154960961 | Timothy A Norris | Counselor | 5026 Raintree Dr, Jackson, MS 39272-5753 | 2019-12-26 |
| 1982243838 | Paula Jane Blocker | Counselor | 401 West St Ste 117, Jackson, MN 56143-1219 | 2019-12-24 |
| 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.