PRIMARY CARE CLINIC OF JACKSON (NPI# 1609309855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609309855 |
Entity Type | Organization |
Organization Name | PRIMARY CARE CLINIC OF JACKSON |
Practice Address |
54 Exeter Rd Ste B Jackson TN 38305-1985 |
Practice Telephone | 7319359463 |
Mailing Telephone | 7312656197 |
Mailing Fax Number | 7312656198 |
Enumeration Date | 2017-04-05 |
Last Update Date | 2020-01-27 |
Authorized Official Name | MRS. KATHY O'CONNOR-WRAY (OWNER) |
Authorized Official Telephone | 7312253639 |
Authorized Official Credential | FNP-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | 000896897 | TN | Ambulatory Health Care Facilities |
Street Address |
54 EXETER RD STE B |
City | JACKSON |
State | TN |
Zip Code | 38305-1985 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891330817 | Nichcole Rau | Nurse Practitioner | 54 Exeter Rd Ste B, Jackson, TN 38305-1985 | 2019-11-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
Find all providers in zip 38305 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972150084 | Wound Management Specialists, LLC | Clinic/Center | 1190 N State St Ste 2a, Jackson, MS 39202-2413 | 2019-08-22 |
1700449329 | Cycle 8 Health Care, LLC | Clinic/Center | 2310 Highway 80 W Ste 2260, Jackson, MS 39204-2383 | 2019-04-18 |
1093286544 | East Endocrine and Metabolism Pllc | Clinic/Center | 3829 Greentree Pl, Jackson, MS 39211-6737 | 2018-12-10 |
1760965206 | Hunter Assets Holding LLC | Clinic/Center | 1035 W Mayes St, Jackson, MS 39213-6100 | 2018-09-11 |
1235634759 | W A Foote Memorial Hospital Inc | Clinic/Center | 2200 Springport Rd Ste 230, Jackson, MI 49202-1432 | 2018-03-27 |
1336644897 | W A Foote Memorial Hospital Inc | Clinic/Center | 3305 Spring Arbor Rd Ste 500, Jackson, MI 49203-3795 | 2018-03-27 |
1730684580 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 210, Jackson, MI 49202-1432 | 2018-03-26 |
1164927844 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 800, Jackson, MI 49202-1432 | 2018-03-26 |
1225532120 | Robert Greer Do, LLC | Clinic/Center | 5345 Farnsworth Dr, Jackson, MS 39211-4604 | 2018-03-23 |
1447761713 | Celestial Health Creations | Clinic/Center | 7 Lakeland Cir Ste 300, Jackson, MS 39216-5022 | 2017-10-13 |
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.