MEDIGO LLC (NPI# 1679119564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679119564 |
| Entity Type | Organization |
| Organization Name | MEDIGO LLC |
| Practice Address |
782 N West St Jackson MS 39202-3017 |
| Mailing Address |
121 Quail Holw Canton MS 39046-9485 |
| Practice Telephone | 6016225499 |
| Practice Fax Number | 6013528452 |
| Mailing Telephone | 6016225499 |
| Mailing Fax Number | 6013528452 |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |
| Authorized Official Name | MR. MARTY D MOSS (MANAGING MEMBER) |
| Authorized Official Telephone | 6016225499 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 121 Quail Holw, Canton, MS 390469485 | 6016225499 | 6013528452 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Medigo LLC | 5 George St. 2, Danbury, CT 06810 |
| Street Address |
782 N WEST ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-3017 |
| 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 | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518581511 | Tracey Bryant | Non-emergency Medical Transport (VAN) | 1160 Rosewood St, Jackson, MS 39212-3966 | 2020-06-04 |
| 1831723154 | Love Thy Neighbor Non Emergency Transportation Service | Non-emergency Medical Transport (VAN) | 5970 Ferncreek Dr, Jackson, MS 39211-2723 | 2020-02-25 |
| 1154968048 | Anwar Abdalnour | Non-emergency Medical Transport (VAN) | 23 Carriage House Dr, Jackson, TN 38305-3934 | 2019-12-10 |
| 1194369264 | Simeon Sobenna Ekugwum | Non-emergency Medical Transport (VAN) | 18 Rob Ln, Jackson, MS 39212-5927 | 2019-11-01 |
| 1437717006 | Door 2 Door | Non-emergency Medical Transport (VAN) | 5110 Curtis St, Jackson, MS 39209-3201 | 2019-05-30 |
| 1053974816 | Tyrie Dunn | Non-emergency Medical Transport (VAN) | 2614 Highway 952, Jackson, LA 70748-3326 | 2019-04-17 |
| 1881157626 | Aa Medical Transit LLC | Non-emergency Medical Transport (VAN) | 811 E River Pl Ste 201, Jackson, MS 39202-3454 | 2019-04-09 |
| 1982166906 | Jnz Transport LLC | Non-emergency Medical Transport (VAN) | 950 W Monroe St Ste G300a, Jackson, MI 49202-2079 | 2019-04-01 |
| 1568931038 | William P Evans | Non-emergency Medical Transport (VAN) | 3979 Skyline Dr, Jackson, MS 39213-6055 | 2018-11-14 |
| 1932688579 | Funchess Transport | Non-emergency Medical Transport (VAN) | 3907 Rainey Rd, Jackson, MS 39212-5323 | 2018-08-13 |
| 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.