ULTRA HEALTH LLC (NPI# 1922469543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922469543 |
| Entity Type | Organization |
| Organization Name | ULTRA HEALTH LLC |
| Other Organization Name | ULTRA HEALTH PROVDERS |
| Practice Address |
36 Pemberton Cv Jackson TN 38305 |
| Mailing Address |
36 Pemberton Cv Jackson TN 38305-5514 |
| Practice Telephone | 7312348120 |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2018-08-29 |
| Authorized Official Name | MR. CHARLES RICHARD JERMAN III (MEMBER) |
| Authorized Official Telephone | 7312348120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ultra Health Provders | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457891145 | Ultra Health LLC | Internal Medicine | 13401 Gov G C Peery Hwy, Pounding Mill, VA 24637-4010 | 2017-03-01 |
| 1285153072 | Ultra Health LLC | Internal Medicine | 1107 Riverview St, Grundy, VA 24614-9481 | 2017-09-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Ultra Health LLC | 112 River Road, Cedar Bluff, Virginia 24609 |
| Street Address |
36 PEMBERTON CV |
| City | JACKSON |
| State | TN |
| Zip Code | 38305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346643087 | Sheila Carlton | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305 | 2014-10-08 |
| 1013572502 | Stephanie Pool | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305-5514 | 2019-05-09 |
| 1568961837 | Evelyn Nicole Jackson | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305 | 2018-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657268 | Subir Ghosh | Internal Medicine | 832 Hwy 15 North, Jackson, KY 41339-8601 | 2005-05-24 |
| 1740741362 | Safa Osman | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2019-03-27 |
| 1962865162 | Daniel Hester | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2016-04-04 |
| 1891194635 | Rola Abi Saleh | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2014-08-18 |
| 1528221009 | Vicky C Pilkington | Internal Medicine | 1200 N State St, Suite 480, Jackson, MS 39202-2000 | 2008-07-06 |
| 1477621324 | Beverly Gwen Windham | Internal Medicine | 2500 North State Street, Department of Medicine Division of Geriatrics, Jackson, MS 39216 | 2006-11-30 |
| 1396816989 | Holland M Addison | Internal Medicine | 1200 N State St, Suite 500, Jackson, MS 39202-2000 | 2006-11-13 |
| 1457375909 | William M. Meeks | Internal Medicine | 2500 North State Street, Department of Medicine/division of Geriatrics, Jackson, MS 39216-4500 | 2006-07-27 |
| 1659398352 | Chere Hunter Peel | Internal Medicine | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2006-07-17 |
| 1013942895 | Kimberly C. Covington Tarver | Internal Medicine | 2500 North State Street, Department of Medicine/division of Geriatrics, Jackson, MS 39216-4500 | 2006-07-11 |
| 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.