DR. FERAS JERADEH-BOURSOULIAN (NPI# 1881910677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881910677 |
| Entity Type | Individual |
| Full Name | DR. FERAS JERADEH-BOURSOULIAN |
| Credential | MD |
| Practice Address |
830 S Gloster St Tupelo MS 38801-4934 |
| Practice Telephone | 6623773000 |
| Mailing Telephone | 6623773000 |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2016-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
23086 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
830 S GLOSTER ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-4934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629078746 | David Smith Talton | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801-4934 | 2005-07-29 |
| 1265031561 | Lauren Hester | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-19 |
| 1972102275 | Matthew Hester | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-19 |
| 1093313397 | Brent Lee Hallmark | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-09 |
| 1457958282 | Benjamin Johnson | Nurse Anesthetist, Certified Registered | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-10-05 |
| 1144837451 | Kayla Ann Jenkins | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4996 | 2020-09-30 |
| 1720695190 | Kimberly Faye Goss | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4996 | 2020-09-29 |
| 1316554900 | Meaghan Reed | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| 1659988269 | Anna Elizabeth Roberts | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| 1487261954 | Helen Paige Long | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2020-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101378 | North Mississippi Medical Center, Inc. | Psychiatry & Neurology | 408 Council Cir Ste B, Tupelo, MS 38801-4949 | 2020-07-21 |
| 1528029618 | Stephen H Landy | Psychiatry & Neurology | 311 S Gloster St Ste 103, Tupelo, MS 38801-4747 | 2006-03-29 |
| 1427041664 | Justin C. Graff | Psychiatry & Neurology | 609 Brunson Dr, Tupelo, MS 38801-4948 | 2005-08-23 |
| 1962495192 | Samuel D. Newell Jr. | Psychiatry & Neurology | 845 S Madison St, Tupelo, MS 38801-4905 | 2005-08-23 |
| 1033740089 | Landy Headache & Esthetics, LLC | Psychiatry & Neurology | 311 S Gloster St Ste 103, Tupelo, MS 38801-4747 | 2020-01-29 |
| 1447623590 | Rahul Brijballabh Chandak | Psychiatry & Neurology | 830 S Gloster St, Tupelo, MS 38801-4934 | 2015-11-10 |
| 1386039683 | Waqas Israr Gilani | Psychiatry & Neurology | 845 S Madison St, Tupelo, MS 38801-4905 | 2015-04-02 |
| 1417357427 | North Mississippi Medical Center Inc. | Psychiatry & Neurology | 830 S Gloster St, Tupelo, MS 38801-4934 | 2014-08-27 |
| 1407266539 | Iwueke Psychatric Clinic | Psychiatry & Neurology | 1601 W Main St Ste D, Tupelo, MS 38801-3300 | 2014-04-29 |
| 1902175821 | North Mississippi Medical Clinics, Inc | Psychiatry & Neurology | 4250 S Eason Blvd, Tupelo, MS 38801-6549 | 2011-12-21 |
| Find all providers in TUPELO | ||||
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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.