MISSISSIPPI ORTHOPAEDIC INSTITUTE (NPI# 1295161404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295161404 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI ORTHOPAEDIC INSTITUTE |
| Practice Address |
15190 Community Rd Ste 120 Gulfport MS 39503-3484 |
| Mailing Address |
15190 Community Rd Suite 120 Gulfport MS 39503 |
| Practice Telephone | 2283282400 |
| Practice Fax Number | 2283284200 |
| Mailing Telephone | 2283282400 |
| Mailing Fax Number | 2283284200 |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |
| Authorized Official Name | ROBERT LANCE JOHANSEN (OWNER) |
| Authorized Official Telephone | 2283282400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 14698 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04232510 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659575728 | Mississippi Orthopaedic Institute | Specialist | 15190 Community Rd, Suite 120, Gulfport, MS 39503-3484 | 2007-06-13 |
| Street Address |
15190 COMMUNITY RD STE 120 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669735379 | Heather Lauren Williams | Occupational Therapist | 15190 Community Rd Ste 120, Gulfport, MS 39503 | 2012-06-18 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790265627 | Mississippi Brain and Spine, Pllc | Non-Pharmacy Dispensing Site | 1 Layfair Drive, Ste 120, Flowood, MS 39232 | 2018-08-20 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1285177543 | Gastroenterology Center of The Midsouth PC | Non-Pharmacy Dispensing Site | 7668b Airways Blvd, Southaven, MS 38671-5304 | 2016-11-18 |
| 1114373586 | Gentex Pharma | Non-Pharmacy Dispensing Site | 121 Marketridge Dr, Suite C, Ridgeland, MS 39157-6027 | 2016-05-04 |
| 1952783078 | Mom 2 Be, LLC | Non-Pharmacy Dispensing Site | 449 Wilkins Wise Rd, Columbus, MS 39705-1756 | 2015-06-25 |
| 1982176426 | Brian Shwer, Dpm | Non-Pharmacy Dispensing Site | 564 Goodman Rd E, Southaven, MS 38671-9526 | 2018-12-21 |
| 1790269439 | Pain Consultants of Alabama, LLC | Non-Pharmacy Dispensing Site | 4105 Hospital Road, Ste 112b, Pascagoula, MS 39581 | 2018-09-19 |
| 1316366503 | Bienville Orthopaedic Specialists LLC | Non-Pharmacy Dispensing Site | 1720a Medical Park Dr Ste 220, Biloxi, MS 39532-2127 | 2014-04-15 |
| 1679826945 | Sotolongo Clinic, Pa | Non-Pharmacy Dispensing Site | 731 S Pear Orchard Rd, Suite 7, Ridgeland, MS 39157-4800 | 2012-10-23 |
| 1578613188 | Urgent Medical Clinic Inc | Non-Pharmacy Dispensing Site | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2007-01-12 |
| Find all providers with the same taxonomy | ||||
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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.