DR. KENYETTA D BRUMMITT (NPI# 1780629147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780629147 |
| Entity Type | Individual |
| Full Name | DR. KENYETTA D BRUMMITT |
| Credential | M.D. |
| Practice Address |
401 Southcrest Cir Ste 104 Southaven MS 38671-6712 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6623491112 |
| Practice Fax Number | 6627722688 |
| Mailing Fax Number | 9012278591 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 22216 | MS | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 055106 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
401 SOUTHCREST CIR STE 104 |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-6712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659735991 | Andrew Stahler | Obstetrics & Gynecology | 401 Southcrest Cir Ste 104, Southaven, MS 38671-6712 | 2016-04-13 |
| 1780764290 | George Sean Tucker | Obstetrics & Gynecology | 401 Southcrest Cir Ste 104, Southaven, MS 38671-6712 | 2006-10-17 |
| 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 | 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 |
|---|---|---|---|---|
| 1093910705 | Gregory Pearce Norwood | Obstetrics & Gynecology | 401 Southcrest Cir Ste 202, Southaven, MS 38671-6719 | 2007-06-20 |
| 1730111063 | Fazal M Manejwala | Obstetrics & Gynecology | 7900 Airways Blvd Ste 2, Southaven, MS 38671-4113 | 2006-07-07 |
| 1811935927 | Elaine Allen Thompson | Obstetrics & Gynecology | 7900 Airways Blvd. Bldg C, Suite 2, Southaven, MS 38671-4114 | 2006-06-02 |
| 1669909651 | Desoto Womens Care Center, Pllc | Obstetrics & Gynecology | 7600 Airways Blvd Ste A, Southaven, MS 38671-5138 | 2017-05-22 |
| 1659735991 | Andrew Stahler | Obstetrics & Gynecology | 401 Southcrest Cir Ste 104, Southaven, MS 38671-6712 | 2016-04-13 |
| 1093112815 | Usha J. Mehta M.d., P.a. | Obstetrics & Gynecology | 7600 Airways Blvd, Suite A, Southaven, MS 38671-5138 | 2014-11-21 |
| 1538485271 | Daniel Lee | Obstetrics & Gynecology | 7900 Airways Blvd Ste 2, Southaven, MS 38671-4113 | 2010-04-19 |
| 1598960437 | Jane Elizabeth Mcadory | Obstetrics & Gynecology | 7900 Airways Blvd Ste 2, Southaven, MS 38671-4113 | 2007-06-20 |
| 1154403962 | Alok Kumar | Obstetrics & Gynecology | 7900 Airways Blvd, Bldg C Suite 2, Southaven, MS 38671-4114 | 2006-10-20 |
| 1780764290 | George Sean Tucker | Obstetrics & Gynecology | 401 Southcrest Cir Ste 104, Southaven, MS 38671-6712 | 2006-10-17 |
| 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.