TELEHEALTHONE, LLC (NPI# 1558718304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558718304 |
| Entity Type | Organization |
| Organization Name | TELEHEALTHONE, LLC |
| Practice Address |
225 Meadowbrook Road Jackson MS 39206 |
| Mailing Address |
152 Watford Parkway Suite 202 Canton MS 39046-7900 |
| Practice Telephone | 6018594342 |
| Practice Fax Number | 8449659592 |
| Mailing Telephone | 6018594342 |
| Mailing Fax Number | 8449659592 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |
| Authorized Official Name | CHRISTPHER B POWE (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6018594342 |
| Authorized Official Credential | ACNP-BC, PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00525567 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336596170 | Telehealthone, LLC | Nurse Practitioner | 301 Yazoo Street, Lexington, MS 39095 | 2016-05-23 |
| 1740637586 | Telehealthone, LLC | Nurse Practitioner | 5760 Hwy 80 East, Pearl, MS 39208 | 2016-05-23 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1861852840 | Telehealthone, LLC | Nurse Practitioner | 101 Mansker Drive, Flora, MS 39071-9790 | 2016-03-03 |
| 1427418409 | Telehealthone, LLC | Nurse Practitioner | 1301 East Peace Street, Canton, MS 39046-7900 | 2016-03-03 |
| 1609284330 | Telehealthone, LLC | General Practice | 1037 Lake Village Cir, Suite A, Brandon, MS 39047-6725 | 2014-07-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TELEHEALTHONE, LLC | 152 Watford Pkwy Dr, Canton, MS 39046-7900 |
| Street Address |
225 MEADOWBROOK ROAD |
| City | JACKSON |
| State | MS |
| Zip Code | 39206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700240397 | Veronique Monique Lynch | Nurse Practitioner | 963 Toms River Rd, Jackson, NJ 08527-5239 | 2016-04-08 |
| 1821423484 | Katherine G Lott | Nurse Practitioner | 6295 Old Canton Rd, Apt 23b, Jackson, MS 39211-2908 | 2013-09-13 |
| 1760618292 | Matthew Edward Flynn | Nurse Practitioner | 971 Lakeland Dr Ste 1052, Jackson, MS 39216-4609 | 2009-06-10 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1437785508 | Katey Andrews | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-03-20 |
| 1144854498 | Katlyn Amason | Nurse Practitioner | 501 Marshall St Ste 200, Jackson, MS 39202-1687 | 2020-02-25 |
| 1194364554 | Erica L Hawkins | Nurse Practitioner | 900 Cooper St, Jackson, MI 49202-3398 | 2020-01-03 |
| 1023664430 | Jennifer Elizabeth Overton | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2019-08-12 |
| 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.