DR. KIMBERLY AMBROSINO (NPI# 1720293566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720293566 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY AMBROSINO |
| Credential | O.D. |
| Practice Address |
6823 Elmore Rd Southaven MS 38671 |
| Mailing Address |
3908 Lake Village Cv Olive Branch MS 38654-5838 |
| Practice Telephone | 6625363680 |
| Mailing Telephone | 6622535534 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 654 | MS | Eye and Vision Services Providers |
| Street Address |
6823 ELMORE RD |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790185999 | Kellie Jones | Optometrist | 1890 Goodman Rd E Ste 10, Southaven, MS 38671-9504 | 2014-08-26 |
| 1770996407 | Desoto Eye and Ear | Optometrist | 5699 Getwell Rd Bldg G2, Southaven, MS 38672-7303 | 2014-06-10 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1881738532 | Jonathan William Wilson | Optometrist | 1890 Goodman Rd E Ste 100, Southaven, MS 38671-9504 | 2007-02-16 |
| 1336287572 | Micheal G Cook Od PC | Optometrist | 3044 Goodman Rd E, Southaven, MS 38672-8760 | 2007-02-01 |
| 1144388539 | Obreineyecare | Optometrist | 354 Stateline Rd W, Southaven, MS 38671-1610 | 2006-12-05 |
| 1235213687 | Alan Charles Smith | Optometrist | 1228 Goodman Rd E Ste 1, Southaven, MS 38671-9540 | 2006-10-24 |
| 1457360679 | Michael G Cook | Optometrist | 3044 Goodman Road East, Southaven, MS 38672-8760 | 2006-08-05 |
| 1982633152 | Southaven Vision Center, Inc. | Optometrist | 484 Church Rd., Southaven, MS 38671-9714 | 2006-07-01 |
| 1023079068 | Heather Michelle Dowdy | Optometrist | 6811 Southcrest Pkwy, Southaven, MS 38671-9538 | 2006-03-29 |
| Find all providers in SOUTHAVEN | ||||
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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.