R M BEREDO M D P L L C (NPI# 1912213604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912213604 |
| Entity Type | Organization |
| Organization Name | R M BEREDO M D P L L C |
| Practice Address |
426 N Jackson St Jackson MI 49201-1235 |
| Practice Telephone | 5177886336 |
| Practice Fax Number | 5177889035 |
| Mailing Telephone | 5177886336 |
| Mailing Fax Number | 5177889035 |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-09-21 |
| Authorized Official Name | DR. ROLANDO M. BEREDO (OWNER) |
| Authorized Official Telephone | 5177886336 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 4301060312 | MI | Other Service Providers |
| Street Address |
426 N JACKSON ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-1235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932197324 | Rafael C Brillantes | Internal Medicine | 426 N Jackson St, Jackson, MI 49201-1235 | 2005-10-10 |
| 1396051892 | R C Brillantes M D P L L C | Specialist | 426 N Jackson St, Jackson, MI 49201-1235 | 2010-08-23 |
| 1093704322 | Rolando Manalo Beredo | Internal Medicine | 426 N Jackson St, Jackson, MI 49201-1235 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1396271565 | Karlisha Britton | Specialist | 7 Lakeland Circle, Suite 300, Jackson, MS 39216 | 2017-05-10 |
| 1922545896 | Paul Edward Ruttle | Specialist | 2640 Trader Rd, Jackson, WY 83001-8321 | 2017-01-30 |
| 1780121483 | Andrew Callis | Specialist | 5303 Old Cape Rd E, Jackson, MO 63755-3850 | 2017-01-19 |
| 1538617055 | Jonathan Parker | Specialist | 95 Riverport Dr, Jackson, TN 38301-5748 | 2016-09-13 |
| 1386096600 | Miriam Bick | Specialist | 4 Florida Pl, Jackson, NJ 08527-1816 | 2016-07-11 |
| 1326429572 | Alonzo Roberts | Specialist | 6110 Highway 18 W, Jackson, MS 39209-9322 | 2015-06-13 |
| 1407289275 | Andrew Francis Charland | Specialist | N168w22224 Main St Ste E, Jackson, WI 53037-9321 | 2013-08-15 |
| 1265872501 | Robyn Abbott Roberts | Specialist | 1904 Lakeland Dr, Suite D, Jackson, MS 39216-5038 | 2013-07-01 |
| 1053754580 | Massage Revolution | Specialist | 210 E Capitol St, Ste M-142, Jackson, MS 39201-2306 | 2013-04-15 |
| Find all providers in JACKSON | ||||
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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.