MEMORIAL HOSPITAL AT GULFPORT (NPI# 1124290051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124290051 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | MEMORIAL PHYSICIAN CLINIC, GULF COAST PEDS |
| Practice Address |
12100 Highway 49 Gulfport MS 39503-3063 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2288320114 |
| Practice Fax Number | 2288311978 |
| Mailing Telephone | 2288966441 |
| Mailing Fax Number | 2288966576 |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2010-01-26 |
| Authorized Official Name | MR. RANDY ROBINSON (DIRECTOR) |
| Authorized Official Telephone | 2288651453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014414 | 05 |
| Other Name | Type Code |
|---|---|
| Memorial Physician Clinic, Gulf Coast Peds | 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 |
12100 HIGHWAY 49 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902847163 | Patricia Danielle Hall | Nurse Practitioner | 12100 Highway 49, Gulfport, MS 39503-3063 | 2006-06-09 |
| 1942462478 | Memorial Hospital At Gulfport | Allergy & Immunology | 12100 Highway 49, Gulfport, MS 39503-3063 | 2008-06-26 |
| 1063527356 | James Holland | Allergy & Immunology | 12100 Highway 49, Gulfport, MS 39503-3063 | 2006-08-20 |
| 1679509293 | Medical Foundation of South Ms | Allergy & Immunology | 12100 Highway 49, Gulfport, MS 39503-3063 | 2006-06-24 |
| 1235171265 | Catherine Donald | Pediatrics | 12100 Highway 49, Gulfport, MS 39503-3063 | 2006-06-12 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730411463 | Memorial Hospital At Gulfport | Pediatrics | 12259 Highway 49, Suite C, Gulfport, MS 39503-3063 | 2010-02-05 |
| 1255446027 | Amy Schepens | Pediatrics | 1285 Spring St, Suite A, Gulfport, MS 39507-3423 | 2006-08-20 |
| 1770698078 | Maureen Holland | Pediatrics | 8950 Lorraine Rd Ste A, Gulfport, MS 39503-4183 | 2006-08-20 |
| 1265547301 | Richard Mccrary | Pediatrics | 1285 Springbridge Street. Suite A, Gulfport, MS 39507-3423 | 2006-08-20 |
| 1841220415 | Medical Foundation of South Ms | Pediatrics | 334 Courthouse Rd, Gulfport, MS 39507-1807 | 2006-07-03 |
| 1285660688 | Garden Park Physician Group Inc | Pediatrics | 416 E Pass Rd, Gulfport, MS 39507-3236 | 2006-06-25 |
| 1326093915 | Erica Frank | Pediatrics | 15190 Community Drive, Suite 330, Gulfport, MS 39503 | 2006-05-23 |
| 1134178262 | Christie Devlin-schroll | Pediatrics | 8950 Lorraine Rd, Gulfport, MS 39503-4177 | 2006-05-08 |
| 1841630266 | Mari Elizabeth Lewis | Pediatrics | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2013-06-29 |
| 1578826558 | Erin Fox | Pediatrics | 15024 Martin Luther King Jr Blvd, Gulfport, MS 39501-8306 | 2012-06-24 |
| 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.