DR. JOSEPH A. KWENTUS (NPI# 1477582096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477582096 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH A. KWENTUS |
| Credential | MD |
| Practice Address |
3450 Highway 80 W Jackson MS 39209-7201 |
| Mailing Address |
P.o. Box 321015 Flowood MS 39232 |
| Practice Telephone | 6013212400 |
| Practice Fax Number | 6013212476 |
| Mailing Telephone | 6014205810 |
| Mailing Fax Number | 6014205811 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-12-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
17834 | MS | Allopathic & Osteopathic Physicians |
| N | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
17834 | MS | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
17834 | MS | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
17834 | MS | Allopathic & Osteopathic Physicians |
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
17834 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | PALMETTO GBA-RAILROAD MED | 860000121 | 01 |
| MS | 00018209 | 05 | |
| MS | 00126737 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3531 Lakeland Drive, Suite 1060 Brentwood Plaza, Flowood, MS 39232 | 6014205810 | 6014205811 |
| Street Address |
3450 HIGHWAY 80 W |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-7201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164468468 | Jeffrey Asgar Ali | Psychiatry & Neurology | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2006-06-22 |
| 1649878216 | Donna Brown | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1831797471 | Tecola Bradley | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1093313660 | Detrick Johnson | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1902404460 | Brittany C Bloodsaw | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1497353957 | Lakeshia L Sutton | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1134727605 | Maya D Dezell | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1275131740 | Karla Banks | Social Worker | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1881292340 | Lyser N Selmon | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-10-15 |
| 1568078566 | Maricus Walker | Counselor | 3450 Highway 80 W, Jackson, MS 39209-7201 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932194 | Saurabh Bipin Bhardwaj | Psychiatry & Neurology | 2500 N State St # H814, Jackson, MS 39216-4500 | 2013-06-19 |
| 1548421795 | Edgar Draper | Psychiatry & Neurology | 2419 Lake Circle, Jackson, MS 39211 | 2008-06-20 |
| 1689854523 | Robert J Brock Md PC | Psychiatry & Neurology | 480 S Cache, Jackson, WY 83001-0941 | 2007-11-08 |
| 1821285610 | Michaela Puno Weller | Psychiatry & Neurology | 3855 Cooper St, Charles Egeler Reception & Guidance Center, Jackson, MI 49201-7547 | 2007-09-26 |
| 1285846774 | Debra E Rodgers Md Pa | Psychiatry & Neurology | 175 Olympia Flds, Jackson, MS 39211-2510 | 2007-05-04 |
| 1497808463 | Virginia J Payne | Psychiatry & Neurology | 1675 Lakeland Dr Ste 200, Jackson, MS 39216-4843 | 2007-01-20 |
| 1952453854 | Marcelita A Bermudez | Psychiatry & Neurology | 4502 Hwy 951, Jackson, LA 70748 | 2007-01-18 |
| 1225180938 | Joe C Scoggin Sr. | Psychiatry & Neurology | 1675 Lakeland Drive, 200 Riverhill Tower, Jackson, MS 39216-4852 | 2007-01-16 |
| 1649352337 | Michael E Stept | Psychiatry & Neurology | 1675 Lakeland Dr, Ste 200, Jackson, MS 39216-4843 | 2006-10-20 |
| 1881702710 | Andrew Charles Bishop | Psychiatry & Neurology | 971 Lakeland Dr Ste 654, Jackson, MS 39216-4605 | 2006-08-29 |
| 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.