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METHODIST LE BONHEUR COMMUNITY OUTREACH
NPI 1174872139
Pediatrics in Jackson, TN

Active since September 06, 2012
77 STONEBRIDGE BLVD, JACKSON, TN 38305(901) 287-5961 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Methodist Le Bonheur Community Outreach NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

METHODIST LE BONHEUR COMMUNITY OUTREACH (NPI 1174872139) is a healthcare organization registered as a pediatrics in Jackson, Tennessee and active in the NPI registry since September 2012. The organization lists Pam Denise Burnett, Manager Of Operations, as its authorized official.

NPPES Registry Identity

NPI1174872139
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMETHODIST LE BONHEUR COMMUNITY OUTREACH
Location Address77 STONEBRIDGE BLVDJackson, TN 38305-2165
Mailing Address1535 Vann DrJackson, TN 38305-2095 · (731) 499-0977 · Fax (731) 499-9939
Phone(901) 287-5961
Organization SubpartNo
Authorized OfficialPam Denise BurnettManager Of Operations · (731) 984-9963
Enumeration DateSeptember 6, 2012
Last NPPES UpdateAugust 19, 2019
✔ NPI 1174872139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
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.
Also ListedNurse Practitioner · Community HealthTaxonomy 363LC1500X
77 STONEBRIDGE BLVD, Jackson, TN 38305
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LISA J DYER DNP, APRN, FNP-BC
Registered Nurse
77 STONEBRIDGE BLVD
JACKSON, TN 38305
Madison County (731) 780-1986
SARAH ROBBINS LMSW
Social Worker
77 STONEBRIDGE BLVD
JACKSON, TN 38305
Madison County (731) 207-0560

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Methodist Le Bonheur Community Outreach's NPI number?

The NPI number for Methodist Le Bonheur Community Outreach is 1174872139. It was assigned to this organization in the NPPES registry on September 6, 2012.

Where is Methodist Le Bonheur Community Outreach located?

Methodist Le Bonheur Community Outreach is located at 77 Stonebridge Blvd, Jackson, TN 38305. The listed phone number is (901) 287-5961.

What is Methodist Le Bonheur Community Outreach's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Methodist Le Bonheur Community Outreach was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.