Jackson Ear Clinic PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

11369 Issued in MS

Legal business name

JACKSON EAR CLINIC PA

Practice address

290 E Layfair Dr
Flowood, MS 39232-9526

Phone

(601) 981-2825

Fax

(601) 981-2827

NPI assigned

Apr 25, 2007

Last updated

Aug 12, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathy Peeples

Title

Office Manager

Phone

(601) 981-2825

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura House Christopher, M.D.

  • Otology & Neurotology Physician
  • Flowood, MS
  • NPI 1366854028
  Medicare reassignment Care Compare group NPD
• Christie L. Gandy, NP

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1780847830
  Medicare reassignment Care Compare group NPD
• James Robert House III, M.D.

  • Specialist
  • Flowood, MS
  • NPI 1588763197
  Medicare reassignment Care Compare group NPD
• Katie Berry, AUD., CCC-A

  • Audiologist
  • Madison, MS
  • NPI 1609143015
  Medicare reassignment NPD
• Susan Sanders Byrd, AUD

  • Audiologist
  • Flowood, MS
  • NPI 1871756635
  Medicare reassignment NPD
• Nicole B Rayburn, AU.D.

  • Audiologist
  • Flowood, MS
  • NPI 1770913246
  Medicare reassignment NPD
• Madison Lynn Anderson, AUD

  • Audiologist
  • Flowood, MS
  • NPI 1922993914
  NPD
• Autumn Monice Barron, AU.D.

  • Audiologist
  • Flowood, MS
  • NPI 1659110336
  NPD
• Natalie Harvel, AUD

  • Audiologist
  • Flowood, MS
  • NPI 1184518847
  NPD
• Klaye Clardy, NP

  • Family Nurse Practitioner
  • Flowood, MS
  • NPI 1396195848
  NPD (past)
• Matthew Cassedy Futvoye, M.D.

  • Orthopaedic Surgery Physician
  • Flowood, MS
  • NPI 1124221601
  NPD (past)
• Emily Corley Hughes, FNP

  • Family Nurse Practitioner
  • Madison, MS
  • NPI 1750799300
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1093934002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 E LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329526",
            "telephone_number": "601-981-2825",
            "fax_number": "601-981-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329526",
            "telephone_number": "601-981-2825",
            "fax_number": "601-981-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON EAR CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "PEEPLES",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-981-2825"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "11369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04586854",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Specialists PLLC
• J & R, Inc. Dba Rhonda Roush LPC (Rhonda Roush LPC)
• Jackson Arthritis Clinic PA
• Jackson Dental Care, PLLC
• Kimyuana Jackson Dorris, PMHNP, AGNP-C
• Jackson Emergency Associates LLC
• Jackson Healthcare for Women PA
• Jackson Heart and Vascular Center LLC
• Jackson Imaging
• Jackson Neurosurgery Clinic, PLLC

• Specialist in Flowood, MS
• Providers in Flowood, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.