DR. CHARLES VACCARO MENENDEZ JR. (NPI# 1629008974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629008974 |
| Entity Type | Individual |
| Full Name | DR. CHARLES VACCARO MENENDEZ JR. |
| Credential | M.D. |
| Practice Address |
3109 Bienville Blvd Ocean Springs MS 39564-4361 |
| Mailing Address |
Po Box 2710 Slidell LA 70459-2710 |
| Practice Telephone | 2287621353 |
| Mailing Telephone | 2287621353 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-03-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
13597 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00117198 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1151 Ocean Springs Rd, Ocean Springs, MS 39564 | 2288750171 | 2288750172 |
| Street Address |
3109 BIENVILLE BLVD |
| City | OCEAN SPRINGS |
| State | MS |
| Zip Code | 39564-4361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982663209 | Susan Bankston | Nurse Anesthetist, Certified Registered | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2006-03-23 |
| 1265057327 | Jonathan Michael Clough | Registered Nurse | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2020-06-14 |
| 1356976013 | Cassie Slaton | Social Worker | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2020-03-03 |
| 1831751759 | Renee Gunn | Dietitian, Registered | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2019-07-01 |
| 1669965505 | Katelyn Shaughnessy | Nurse Anesthetist, Certified Registered | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2018-06-13 |
| 1003328956 | Hannah Michelle Lambey | Dietitian, Registered | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2017-11-01 |
| 1003342916 | Hannah Rosemeyer | Speech-Language Pathologist | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2017-05-11 |
| 1518400035 | Chaeleena Ladd | Nurse Practitioner | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2016-12-01 |
| 1376928630 | 'proxsys Rx - Rush, LLC | Pharmacy | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2015-07-28 |
| 1154712248 | Kelsy Seymour | Nurse Practitioner | 3109 Bienville Blvd, Suite 340, Ocean Springs, MS 39564-4361 | 2015-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996401 | Shelby Bourgeois | Speech-Language Pathologist | 108 Heron Park Pl, Ocean Springs, MS 39564 | 2020-09-10 |
| 1467010520 | Rachel Stephenie Knox | Student in an Organized Health Care Education/Training Program | 81mdss/gme 301 Fisher St., Rm 1g123, Keesler Afb, MS 39564 | 2019-06-04 |
| 1457839292 | Polly Anne Lampon | Registered Nurse | 2301 Rue Beaux Chenes, Ocean Springs, MS 39564 | 2018-08-03 |
| 1578062725 | Gulf Coast Sleep Medicine LLC | Clinic/Center | 2112 Bienville Blvd., Suite P, Ocean Springs, MS 39564 | 2018-02-02 |
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1386016749 | L. Randy Buntyn, D.m.d., Pllc | Dentist | 1203 Government St., Ocean Springs, MS 39564 | 2015-10-26 |
| 1467835629 | Msmobileyes Inc. | Optometrist | 2510 Bileville Blvd, Ocean Springs, MS 39564 | 2015-07-07 |
| 1659760999 | Clark Jamison Levi | Pharmacist | 1019 Government Street Suite F & D, Ocean Springs, MS 39564 | 2015-01-09 |
| 1932545480 | Therese Anne Hanna | Nurse Practitioner | 6900 Washington Avenue, Ocean Springs, MS 39564 | 2013-05-10 |
| 1346589421 | Jennah Claine Ladner | Nurse Practitioner | 1137 Ocean Springs Road, Ocean Springs, MS 39564 | 2013-02-08 |
| Find all providers in zip 39564 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851709851 | Telerad of Ms Account Management LLC | Radiology | 3201 Oakleigh Cir, Ocean Springs, MS 39564-5861 | 2014-07-23 |
| 1992758379 | Douglas G Cosentino | Radiology | 3535 Bienville Blvd, Ocean Springs, MS 39564-5705 | 2006-05-18 |
| 1477515898 | Brian Twedt | Radiology | 202 Rue St Denis, Ocean Springs, MS 39564-3012 | 2006-04-03 |
| 1437558533 | Mississippi Coastal Mri LLC | Radiology | 3890 Bienville Blvd, Ocean Springs, MS 39564-5803 | 2014-08-14 |
| 1114958089 | James Moore Carter | Radiology | 3109 Bienville Blvd, Ocean Springs, MS 39564-4361 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184185092 | North Mississippi Radiology Services LLC | Radiology | 7420 Guthrie Dr N Ste 105, Southaven, MS 38671-5857 | 2019-03-26 |
| 1063890754 | Phil Otis Nelson Jr. | Radiology | 146 Ridge Dr, Jackson, MS 39216-4109 | 2015-05-13 |
| 1033532825 | Nadia Aboussouan Tyson | Radiology | 675 N Livingston Rd, Ridgeland, MS 39157-5034 | 2014-01-29 |
| 1124459490 | James Vaiden Ferguson Jr. | Radiology | 3638 Lyles Dr, Oxford, MS 38655-5709 | 2013-12-11 |
| 1487904173 | Mid Delta Radiology Associates, LLC | Radiology | 130 River Club Cir, Clarksdale, MS 38614-9725 | 2012-09-11 |
| 1043587629 | Clifton L Hester Jr. | Radiology | 607 E Leake St, Clinton, MS 39056-4300 | 2011-11-26 |
| 1912298498 | Lisa Mabry Smith | Radiology | 14257 Dedeaux Rd, Gulfport, MS 39503-3369 | 2011-05-02 |
| 1134446743 | Thomas Edward Panico | Radiology | 4213 Lakeland Drive, Flowood, MS 39232-9212 | 2010-04-23 |
| 1487808408 | Gulf Shores Radiology Assoicates | Radiology | 1207 Wood Duck Cv, Oxford, MS 38655-7347 | 2008-11-05 |
| 1679775001 | Molecular Imaging Assoc Pllc | Radiology | 136 Fioranelli Dr, Greenville, MS 38701-7313 | 2007-06-05 |
| Find all providers with the same taxonomy | ||||
| City | OCEAN SPRINGS |
| Zip Code | 39564 |
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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.