1972274421 NPI number — JESSICA MAGEN RAMSEY

Table of content: JESSICA MAGEN RAMSEY (NPI 1972274421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972274421 NPI number — JESSICA MAGEN RAMSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMSEY
Provider First Name:
JESSICA
Provider Middle Name:
MAGEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972274421
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 RIDDLES BEND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAINBOW CITY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35906-7678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-393-0303
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6019 WALNUT GROVE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-226-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  1-123320 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 31839 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)