JACKSON HEALTHCARE FOR WOMEN PA (NPI# 1689717530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689717530 |
| Entity Type | Organization |
| Organization Name | JACKSON HEALTHCARE FOR WOMEN PA |
| Practice Address |
971 Lakeland Dr Suite 400 Jackson MS 39216-4643 |
| Practice Telephone | 6019821670 |
| Practice Fax Number | 6019820219 |
| Mailing Telephone | 6019821670 |
| Mailing Fax Number | 6019820219 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN W COOK (PRESIDENT) |
| Authorized Official Telephone | 6019821670 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902941768 | Jackson Healthcare for Women Pa | Obstetrics & Gynecology | 1047 N Flowood Dr, Jackson, MS 39232-9533 | 2007-02-20 |
| 1922143650 | Jackson Healthcare for Women Pa | Obstetrics & Gynecology | 291 E Layfair Dr, Flowood, MS 39232-9527 | 2007-02-20 |
| Street Address |
971 LAKELAND DR SUITE 400 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661789 | Maurice James | Ophthalmology | 971 Lakeland Dr, Ste 563, Jackson, MS 39216-4607 | 2005-07-01 |
| 1891226643 | Matthew Milling | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Suite 202, Jackson, MS 39216-4643 | 2017-03-23 |
| 1134667843 | Bonney Neill Simmons | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2017-02-02 |
| 1437694320 | Kristen Degelman | Nurse Practitioner | 971 Lakeland Dr, Suite 401, Jackson, MS 39216-4643 | 2016-12-30 |
| 1134671787 | Jackson Thyroid & Endocrine Clinic Pllc | Internal Medicine | 971 Lakeland Dr, Suite 353, Jackson, MS 39216-4643 | 2016-10-31 |
| 1609223205 | Sally Sullivan | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2016-05-24 |
| 1932576998 | Misty Gaines | Nurse Practitioner | 971 Lakeland Dr, Suite 657, Jackson, MS 39216-4643 | 2015-08-26 |
| 1659755676 | Angela B. Mccallum | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2015-07-20 |
| 1356732481 | St Dominic Medical Associates LLC | Internal Medicine | 971 Lakeland Dr, Suite, Jackson, MS 39216-4643 | 2015-02-11 |
| 1689063067 | St Dominic Medical Associates LLC | Urology | 971 Lakeland Dr, Suite 360, Jackson, MS 39216-4643 | 2015-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528477007 | Shandeidra Nicole Bonds-singleton | Obstetrics & Gynecology | 657 Skyline Dr Dept Of, Jackson, TN 38301-3903 | 2014-08-08 |
| 1477995454 | Camille Stephanie Mellijor-figg | Obstetrics & Gynecology | 430 S Cache St, Jackson, WY 83001-8692 | 2013-07-19 |
| 1245535392 | River Oaks Management Company, LLC | Obstetrics & Gynecology | 1860 Hospital Dr, Suite 103, Jackson, MS 39204-3410 | 2011-01-21 |
| 1134374291 | Joy Luck | Obstetrics & Gynecology | 2009 W Michigan Ave, Jackson, MI 49202-4010 | 2008-11-17 |
| 1720241532 | Henry Earl West | Obstetrics & Gynecology | 657 Skyline Dr Ste B, Jackson, TN 38301-3903 | 2008-07-02 |
| 1649432626 | William Ashley Hood D.o. | Obstetrics & Gynecology | 1020 River Oaks Dr Ste 430, Jackson, MS 39232-9500 | 2008-06-30 |
| 1790956837 | Jackson Ob-gyn Plc | Obstetrics & Gynecology | 306 W Washington, Ste 102, Jackson, MI 49201 | 2008-03-17 |
| 1295863611 | Richard Nmi Ignatius | Obstetrics & Gynecology | 23 Conor Rd, Jackson, NJ 08527-3781 | 2007-02-28 |
| 1902941768 | Jackson Healthcare for Women Pa | Obstetrics & Gynecology | 1047 N Flowood Dr, Jackson, MS 39232-9533 | 2007-02-20 |
| 1689747396 | Shore Point Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 22 Linda Dr, Jackson, NJ 08527-5026 | 2006-11-17 |
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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.