Infectious Disease Consultants of Jackson, PC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

INFECTIOUS DISEASE CONSULTANTS OF JACKSON, PC

Practice address

43 Oakhaven Dr
Jackson, TN 38305-6801

Phone

(731) 425-6067

Fax

(731) 660-8739

NPI assigned

Oct 19, 2006

Last updated

May 16, 2008By 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

David Aherrera

Title

Director

Phone

(731) 425-6067

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 7

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.

• Julie Tan Antique, MD

  • Infectious Disease Physician
  • Jackson, TN
  • NPI 1982623591
  Medicare reassignment NPD
• Barbara Excell Menzies, M.D.

  • Infectious Disease Physician
  • Jackson, TN
  • NPI 1144330291
  Medicare reassignment NPD
• Priscilla Sioson-Aherrera, MD

  • Infectious Disease Physician
  • Jackson, TN
  • NPI 1346275906
  Medicare reassignment NPD
• Tina Wilson, M.D.

  • Infectious Disease Physician
  • Jackson, TN
  • NPI 1376579854
  Medicare reassignment NPD
• Ellena Henderson, MD

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1285689091

  Infectious Disease

  NPD (past)
• Debra L Rainey, M.D.

  • Infectious Disease Physician
  • Jackson, TN
  • NPI 1952336513
  NPD (past)
• Abdul Qavi, M.D.

  • Infectious Disease Physician
  • Mesquite, TX
  • NPI 1780655779
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1316029648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-8759",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 OAKHAVEN DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056801",
            "telephone_number": "731-425-6067",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE CONSULTANTS OF JACKSON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "AHERRERA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "731-425-6067"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Infectious Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.