MO SERVICES LLC (NPI# 1124587829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124587829 |
| Entity Type | Organization |
| Organization Name | MO SERVICES LLC |
| Practice Address |
15190 Community Rd. Suite 120 Gulfport MS 39503-3484 |
| Practice Telephone | 2283282400 |
| Practice Fax Number | 2283284200 |
| Mailing Telephone | 2283282400 |
| Mailing Fax Number | 2283284200 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |
| Authorized Official Name | ROBERT LANCE JOHANSEN (CEO) |
| Authorized Official Telephone | 2283282400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04232510 | 05 |
| Street Address |
15190 COMMUNITY RD. SUITE 120 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3484 |
| 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 | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463788 | Robert Lance Johansen | Orthopaedic Surgery | 15190 Community Rd, Suite 120, Gulfport, MS 39503-3484 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720303639 | Thomas David Tarity | Orthopaedic Surgery | 301 Fisher St, Orthopedic Surgery Clinic, Keesler Afb, MS 39534-2508 | 2010-04-02 |
| 1750590196 | Benjamin Stronach | Orthopaedic Surgery | 2500 North State Street, Department of Orthopedics, Jackson, MS 35216-4500 | 2007-05-22 |
| 1003951724 | Trevor Reed Pickering | Orthopaedic Surgery | 1325 E Fortification St, Jackson, MS 39202-2442 | 2007-02-20 |
| 1295872174 | Ashish Anand | Orthopaedic Surgery | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2007-01-31 |
| 1902835044 | Richard A Conn | Orthopaedic Surgery | 3688 Veterans Memorial Dr, Suite 200, Hattiesburg, MS 39401-8246 | 2006-07-01 |
| 1679516017 | James L Hughes Jr. | Orthopaedic Surgery | 1410 E Woodrow Wilson Ave, Jackson, MS 39216-5114 | 2006-06-14 |
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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.