MEMORIAL HOSPITAL AT GULFPORT (NPI# 1093031494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093031494 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | PHYSICIANS CLINIC AT MHG |
| Practice Address |
15190 Community Rd Suite 240 Gulfport MS 39503-3485 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2285392242 |
| Practice Fax Number | 2285392712 |
| Mailing Telephone | 2288640854 |
| Mailing Fax Number | 2288651457 |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2011-01-03 |
| Authorized Official Name | MR. JEFF T STEINER (VP OF FINANCES) |
| Authorized Official Telephone | 2288653469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | TRICARE GROUP | 006 | 01 |
| MS | 06372030 | 05 |
| Other Name | Type Code |
|---|---|
| PHYSICIANS CLINIC AT MHG | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215354402 | Memorial Hospital At Gulfport | Physical Therapy Assistant | 2781 C.t. Switzer, Suite 404, Biloxi, MS 39531 | 2014-03-25 |
| 1609203173 | Memorial Hospital At Gulfport | Internal Medicine | 1756 Popps Ferry Rd Ste A, Biloxi, MS 39532-2118 | 2013-09-30 |
| 1285070672 | Memorial Hospital At Gulfport | Occupational Therapist | 2781 C. T. Switzer Dr., Suite 404, Biloxi, MS 39531-4535 | 2013-05-13 |
| 1205129137 | Memorial Hospital At Gulfport | Family Medicine | 20006 Hwy 53, 7 Sunshine Place, Gulfport, MS 39503-0000 | 2011-05-25 |
| 1275848889 | Memorial Hospital At Gulfport | Internal Medicine | 4405 E Aloha Dr, Suite 1, Diamondhead, MS 39525-3380 | 2010-08-09 |
| 1649585258 | Memorial Hospital At Gulfport | Internal Medicine | 784 Vieux Marche Mall, Biloxi, MS 39530-3822 | 2010-08-09 |
| 1730411463 | Memorial Hospital At Gulfport | Pediatrics | 12259 Highway 49, Suite C, Gulfport, MS 39503-3063 | 2010-02-05 |
| 1649404435 | Memorial Hospital At Gulfport | Internal Medicine | 970 Tommy Munro Dr, Biloxi, MS 39532-2130 | 2009-05-07 |
| 1295978435 | Memorial Hospital At Gulfport | Psychiatry & Neurology | 5407 Indian Hill Blvd, Diamondhead, MS 39525-3324 | 2009-04-17 |
| 1255524211 | Memorial Hospital At Gulfport | Clinic/Center | 1340 Broad Ave Ste 220, Gulfport, MS 39501-2404 | 2007-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| Street Address |
15190 COMMUNITY RD SUITE 240 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337770 | Ronald David Evans | Surgery | 15190 Community Rd, Suite 250, Gulfport, MS 39503-3485 | 2005-06-21 |
| 1861010159 | Singing River Gulfport | Clinic/Center | 15190 Community Rd, Gulfport, MS 39503-3485 | 2020-07-13 |
| 1427594480 | Christina Barnes | Nurse Practitioner | 15190 Community Rd, Suite 110, Gulfport, MS 39503-3485 | 2017-01-16 |
| 1417400896 | David N Johnston Jr. | Nurse Anesthetist, Certified Registered | 15190 Community Rd, Gulfport, MS 39503-3485 | 2016-08-02 |
| 1023469244 | Michelle Wright Taylor | Nurse Practitioner | 15190 Community Rd, Ste 220, Gulfport, MS 39503-3485 | 2016-06-29 |
| 1396107330 | D Balder Md, Pllc | Specialist | 15190 Community Rd, Gulfport, MS 39503-3485 | 2016-03-28 |
| 1154725562 | Matthew James Ladner | Physical Therapy Assistant | 15190 Community Rd, Gulfport, MS 39503-3485 | 2014-10-14 |
| 1255770558 | Amy Lynn Scheller | Surgery | 15190 Community Rd, Gulfport, MS 39503-3485 | 2013-06-19 |
| 1003254525 | Philip D Myers | Orthopaedic Surgery | 15190 Community Rd, Gulfport, MS 39503 | 2013-06-06 |
| 1508202268 | Jeremy W Owens, Md, PC | Psychiatry & Neurology | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2013-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678000 | The Urology Clinic, LLC | Urology | 14231 Seaway Rd Ste 6000, Gulfport, MS 39503-4628 | 2019-06-20 |
| 1407969207 | Memorial Hospital At Gulfport | Urology | 1340 Broad Ave Ste 210, Gulfport, MS 39501-2465 | 2006-08-16 |
| 1871737064 | Jacob N Jorns | Urology | 1340 Broad Ave Ste 210, Gulfport, MS 39501-2465 | 2009-05-01 |
| 1669619912 | Memorial Hospital of Gulfport | Urology | 1340 Broad Ave, Ste 210, Gulfport, MS 39501-2404 | 2009-01-08 |
| 1962690255 | Memorial Hospital At Gulfport | Urology | 1340 Broad Ave, Suite 210, Gulfport, MS 39501-2404 | 2007-10-11 |
| 1962557157 | Southern Urology Associates LLC | Urology | 12330 Ashley Dr, Gulfport, MS 39503-2737 | 2007-01-25 |
| 1194825216 | Paige C White | Urology | 1340 Broad Ave, Suite 210, Gulfport, MS 39501-2404 | 2006-09-25 |
| 1548285968 | David Champ Weeks | Urology | 1340 Broad Ave, Suite 210, Gulfport, MS 39501-2404 | 2006-07-13 |
| 1760417612 | Arthur M Matthews Jr. | Urology | 15190 Community Rd, Suite 370, Gulfport, MS 39503-3485 | 2006-07-11 |
| 1619919917 | Southern Urology Associates LLC | Urology | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2006-06-12 |
| Find all providers in GULFPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.