THE CHILDREN'S CLINIC OF WEST TENNESSEE P.A. (NPI# 1942469606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942469606 |
| Entity Type | Organization |
| Organization Name | THE CHILDREN'S CLINIC OF WEST TENNESSEE P.A. |
| Practice Address |
264 Coatsland Dr Jackson TN 38301-3948 |
| Practice Telephone | 7314231500 |
| Practice Fax Number | 7314230342 |
| Mailing Telephone | 7314231500 |
| Mailing Fax Number | 7314230342 |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |
| Authorized Official Name | DR. DAVID LESLIE SELF JR. (PARTNER) |
| Authorized Official Telephone | 7314231500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
264 COATSLAND DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669560397 | Bruce B Maley | Pediatrics | 264 Coatsland Dr, Jackson, TN 38301-3948 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982224895 | Vpa PC | Pediatrics | 111 E Capitol St Ste 215, Jackson, MS 39201-2108 | 2020-04-21 |
| 1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
| 1891145850 | Abdullah Sharaf | Pediatrics | 760 W Franklin St # 49201, Jackson, MI 49201-2048 | 2016-06-20 |
| 1427427152 | Karin L Klee Md | Pediatrics | 555 E Broadway Ave Ste 216, Jackson, WY 83001-8640 | 2015-09-23 |
| 1073992699 | Muna Balkash | Pediatrics | 4645 Eagle Dr, Jackson, MI 49201-9748 | 2015-05-28 |
| 1295147809 | Jayasree Vasudevan Nair | Pediatrics | 100 Mission Blvd Ste 2600, Jackson, CA 95642-2536 | 2014-05-30 |
| 1669891099 | Jacquelin Foss Hardenbrook | Pediatrics | 555 E Broadway Ave Ste 202, Jackson, WY 83001-8640 | 2014-04-14 |
| 1871805093 | Jesse Alfred Miller Jr. | Pediatrics | 1804 Hwy 45 Bypass, Jackson, TN 38305 | 2010-07-02 |
| 1861647489 | Elizabeth Keeling Hensley | Pediatrics | 2046 Petit Bois St S, Jackson, MS 39211-6709 | 2008-11-24 |
| 1225203011 | Tom Pockat Md PC | Pediatrics | 555 E. Broadway St., Suite 202, Jackson, WY 83001-4182 | 2008-04-23 |
| 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.