SOUTHEAST UROGYN LLC (NPI# 1548513617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548513617 |
Entity Type | Organization |
Organization Name | SOUTHEAST UROGYN LLC |
Practice Address |
501 Marshall St Suite 600 Jackson MS 39202-1651 |
Practice Telephone | 6019486540 |
Practice Fax Number | 6013261501 |
Mailing Telephone | 6019486540 |
Mailing Fax Number | 6013261501 |
Enumeration Date | 2012-10-26 |
Last Update Date | 2016-01-20 |
Authorized Official Name | MRS. JULIE FERGUSON (ADMINISTRATOR) |
Authorized Official Telephone | 6019486540 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
Street Address |
501 MARSHALL ST SUITE 600 |
City | JACKSON |
State | MS |
Zip Code | 39202-1651 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932176641 | Sabra Sullivan | Dermatology | 501 Marshall St, Suite 606, Jackson, MS 39202-1651 | 2006-03-01 |
1598328684 | Caroline Douglass Peeples | Registered Nurse | 501 Marshall St, Jackson, MS 39202-1651 | 2019-04-15 |
1548655053 | Mississippi Urology Outpatient Surgery Center, LLC | Clinic/Center | 501 Marshall St, Suite 201, Jackson, MS 39202-1651 | 2015-04-01 |
1639586076 | Baptist Heart | Internal Medicine | 501 Marshall St, Suite 104, Jackson, MS 39202-1651 | 2014-07-17 |
1568709574 | Medical Foundation of Central Ms | Surgery | 501 Marshall St, Suite 500, Jackson, MS 39202-1651 | 2013-01-10 |
1417291451 | Urogyn Diagnostics LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-11-15 |
1477825800 | The Medical Foundation of Central Mississippi | Clinic/Center | 501 Marshall St, Suite 100, Jackson, MS 39202-1651 | 2012-02-01 |
1265712145 | Laurie Selman Nimon | Nurse Practitioner | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2011-08-23 |
1992034771 | Southeast Urogynecology Pa | Urology | 501 Marshall St, Suite 607-a, Jackson, MS 39202-1651 | 2009-12-08 |
1053646877 | Barrie E Aden | Audiologist | 501 Marshall St, Suite 602, Jackson, MS 39202-1651 | 2009-10-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
Find all providers in zip 39202 |
Taxonomy Code | 207VF0040X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Female Pelvic Medicine and Reconstructive Surgery |
A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962679241 | Paul H Moore IIi | Obstetrics & Gynecology | 2500 North State Street, Jackson, MS 39216-4500 | 2008-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548688310 | Ovation Womens Wellness LLC | Obstetrics & Gynecology | 111 Colony Crossing Way Ste 230, Madison, MS 39110-6833 | 2014-03-31 |
1902807878 | Thomas Clifton Pitman | Obstetrics & Gynecology | 7736 Airways Blvd, Southaven, MS 38671-5306 | 2005-08-02 |
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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.