MEDICAL FOUNDATION, INC. (NPI# 1770985020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770985020 |
| Entity Type | Organization |
| Organization Name | MEDICAL FOUNDATION, INC. |
| Other Organization Name | WOMAN'S GROUP - PHILADELPHIA |
| Practice Address |
1056 Holland Ave Suite A Philadelphia MS 39350-9121 |
| Mailing Address |
Po Box 5183 Meridian MS 39302-5183 |
| Practice Telephone | 6014821002 |
| Practice Fax Number | 6014821190 |
| Mailing Telephone | 6017034282 |
| Mailing Fax Number | 6017033080 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | DON LARKIN KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 6017039614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Woman's Group - Philadelphia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194191684 | Medical Foundation, Inc. | Family Medicine | 5100 Hwy 21 South, Preston, MS 39354 | 2015-08-19 |
| 1275930174 | Medical Foundation, Inc. | Anesthesiology | 1200 16th Ave, Meridian, MS 39301-4209 | 2014-11-21 |
| 1467857102 | Medical Foundation, Inc. | Clinical Medical Laboratory | 1306 20th Avenue, Meridian, MS 39301 | 2014-10-23 |
| 1891353462 | Medical Foundation, Inc. | Obstetrics & Gynecology | 2303 13th St, Meridian, MS 39301-3940 | 2019-05-30 |
| 1386118602 | Medical Foundation, Inc. | Pediatrics | 252 Northside Dr, Newton, MS 39345-9756 | 2019-01-21 |
| 1235598624 | Medical Foundation, Inc. | Obstetrics & Gynecology | 2401 16th St, Meridian, MS 39301-3950 | 2016-02-15 |
| 1346654027 | Medical Foundation, Inc. | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2014-06-20 |
| 1144633363 | Medical Foundation, Inc. | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-06-05 |
| 1811300395 | Medical Foundation, Inc. | Psychiatry & Neurology | 1800 12th St, Meridian, MS 39301-4158 | 2014-06-03 |
| 1285046987 | Medical Foundation, Inc. | Obstetrics & Gynecology | 1221 24th Ave, Meridian, MS 39301-3926 | 2014-05-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEDICAL FOUNDATION, INC. | 1314 19th Ave, Meridian, MS 39301-4116 |
| Street Address |
1056 HOLLAND AVE SUITE A |
| City | PHILADELPHIA |
| State | MS |
| Zip Code | 39350-9121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578545968 | Michael B. Shrock | Family Medicine | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2005-11-19 |
| 1588194708 | Hannah Johnson | Nurse Practitioner | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2017-06-20 |
| 1609329358 | Samantha Mosby | Family Medicine | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2016-07-29 |
| 1619357050 | Amber Thomas | Nurse Practitioner | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2015-06-01 |
| 1053750125 | Anderson Regional Medical Center | Clinic/Center | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2013-06-21 |
| 1598053225 | Deborah Michelle Washburn | Physician Assistant | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2011-07-15 |
| 1881909125 | Brenda Thrash | Nurse Practitioner | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2010-08-11 |
| 1255654778 | Donald Grant Guild | Family Medicine | 1056 Holland Ave, Philadelphia, MS 39350-9121 | 2010-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
| Find all providers in zip 39350 | ||||
| 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 |
|---|---|---|---|---|
| 1962027557 | Tal Avigal Lee | Obstetrics & Gynecology | 1109 Green St Apt 11, Philadelphia, PA 19123-3326 | 2020-06-10 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1477011401 | Diane D. Harrison | Obstetrics & Gynecology | 236 Philip Pl, Philadelphia, PA 19106-3902 | 2019-03-08 |
| 1720570963 | Tiffany Fernandes Gee | Obstetrics & Gynecology | 3401 N Broad St Fl 7, Philadelphia, PA 19140-5189 | 2018-06-04 |
| 1881114742 | Andrea Jasmine Leung | Obstetrics & Gynecology | 5501 Old York Rd # 1-1616, Philadelphia, PA 19141-3018 | 2017-06-22 |
| 1548798093 | Dimitrios Nasioudis | Obstetrics & Gynecology | 3400 Spruce Street, 1 West Gates, Hellen O. Dickens Center for Women's Health, Philadelphia, PA 19104-3123 | 2017-05-30 |
| 1811449697 | West Cayuga Medicine PC | Obstetrics & Gynecology | 257 W Cayuga St, Philadelphia, PA 19140-2439 | 2016-10-27 |
| 1447631536 | Clinton Veselis | Obstetrics & Gynecology | 3401 N Broad St Dept Of, Philadelphia, PA 19140 | 2015-06-15 |
| 1811378979 | Nishanth Sidduri | Obstetrics & Gynecology | 400 W Allegheny Ave Ste 5b, Philadelphia, PA 19133-3614 | 2015-06-15 |
| 1396158820 | Elizabeth Carey Banks | Obstetrics & Gynecology | 800 Walnut St Fl 12, Philadelphia, PA 19107-5176 | 2014-06-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 39350 |
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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.