Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Methodist Le Bonheur Community Outreach

Organization Pediatrics Physician · NPI 1174872139

Methodist Le Bonheur Community Outreach is a Pediatrics Physician in Jackson, Tennessee. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2

Practice location Address checks out

77 Stonebridge Blvd
Jackson, TN 38305-2165
Phone: (901) 287-5961
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Community Health Nurse Practitioner Taxonomy 363LC1500X

Record details

NPI number1174872139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pam Burnett — Manager Of Operations · (731) 984-9963
NPI enumeratedSeptember 6, 2012
Last updated in NPPESAugust 19, 2019
Mailing address1535 Vann Dr, Jackson, TN 38305-2095

Other providers in Jackson