MR. RICK A PSONAK (NPI# 1538258736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538258736 |
| Entity Type | Individual |
| Full Name | MR. RICK A PSONAK |
| Credential | CPO |
| Practice Address |
777 Lakeland Dr Jackson MS 39216-4611 |
| Mailing Address |
Po Box 3188 Jackson MS 39207-3188 |
| Practice Telephone | 6019846525 |
| Practice Fax Number | 6019845485 |
| Mailing Telephone | 6019846525 |
| Mailing Fax Number | 6019845485 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | CPO1452 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | CERIFICATION | CPO1452 | 01 |
| MS | 02901340 | 05 |
| Street Address |
777 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497126775 | Damon Bagley-ayres | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2015-10-13 |
| 1790091411 | April Webb | Speech-Language Pathologist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-08-19 |
| 1548583172 | Charles Reggie Kennedy Sr. | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-03-10 |
| 1285956482 | Michelle Andrea Lowrie | Speech-Language Pathologist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-02-16 |
| 1487806899 | Josephine Pillow Duke | Speech-Language Pathologist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2008-10-16 |
| 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 | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003338898 | Joshua Paul Ahlstrom | Orthotist | 1407 E Michigan Ave, Jackson, MI 49202-3517 | 2017-07-12 |
| 1477894848 | Duane R Hoeppner | Orthotist | 1005 E Michigan Ave, Jackson, MI 49201-2405 | 2013-03-11 |
| 1184149551 | David Trevisan | Orthotist | 1407 E Michigan Ave, Jackson, MI 49202-3517 | 2017-08-07 |
| 1497126775 | Damon Bagley-ayres | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2015-10-13 |
| 1588035257 | Stephen Bret Lee | Orthotist | 2500 N State St, Jackson, MS 39216-4500 | 2015-10-07 |
| 1417362849 | Amy R Adcox | Orthotist | 2500 N State St, Jackson, MS 39216-4500 | 2014-06-24 |
| 1679916183 | Zachary Douglas Myrick | Orthotist | 2 Old River Pl Ste D, Jackson, MS 39202-3435 | 2013-04-15 |
| 1548583172 | Charles Reggie Kennedy Sr. | Orthotist | 777 Lakeland Dr, Jackson, MS 39216-4611 | 2010-03-10 |
| 1952586786 | Kevin Scribner | Orthotist | 2500 N State St, Jackson, MS 39216-4500 | 2007-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740823178 | Altair Incorporated | Orthotist | 4388 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2019-10-17 |
| 1659869048 | Alberto L Alvarez | Orthotist | 3506 Washington Ave Ste D, Gulfport, MS 39507-3102 | 2018-05-01 |
| 1750833786 | William J. Kenny | Orthotist | 4201 Highway 11 N Ste D, Picayune, MS 39466-2014 | 2016-10-25 |
| 1902393614 | William K Wade | Orthotist | 3004 Bienville Blvd, Ocean Springs, MS 39564-4370 | 2018-04-18 |
| 1093763005 | Andrew S Kirby | Orthotist | 2323 5th St N, Columbus, MS 39705-2213 | 2006-05-04 |
Please comment or provide details below to improve the information on MR. RICK A PSONAK.
| 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.