MEMORIAL HOSPITAL AT GULFPORT (NPI# 1295978435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295978435 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | MEMORIAL SPECIALTY CLINIC |
| Practice Address |
5407 Indian Hill Blvd Diamondhead MS 39525-3324 |
| Mailing Address |
1612 31st Ave Gulfport MS 39501-2750 |
| Practice Telephone | 2282556129 |
| Practice Fax Number | 2282556431 |
| Mailing Telephone | 2288651453 |
| Mailing Fax Number | 2288651451 |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-07-10 |
| Authorized Official Name | JEFF STEINER (CFO, VP OF FINANCE) |
| Authorized Official Telephone | 2288653469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02203599 | 05 |
| Other Name | Type Code |
|---|---|
| MEMORIAL SPECIALTY CLINIC | 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 |
| 1255524211 | Memorial Hospital At Gulfport | Clinic/Center | 1340 Broad Ave Ste 220, Gulfport, MS 39501-2404 | 2007-08-23 |
| 1053535781 | Memorial Hospital At Gulfport | Clinic/Center | 12057 Highway 49 Ste C, Gulfport, MS 39503-3177 | 2007-04-12 |
| 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 |
5407 INDIAN HILL BLVD |
| City | DIAMONDHEAD |
| State | MS |
| Zip Code | 39525-3324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609215391 | Notre Dame Health System | Hospice Care, Community Based | 5407 Indian Hill Blvd, Diamondhead, MS 39525-3324 | 2013-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447762042 | South Mississippi Home Care, LLC | Home Health | 56128 Diamondhead Dr E, Diamondhead, MS 39525 | 2017-11-04 |
| 1093247553 | Deedy Killen | Registered Nurse | 124a Lakeside Villa Bldg C, Diamondhead, MS 39525 | 2017-04-03 |
| 1730502055 | Hancock Medical Health Services | Clinic/Center | 5435 Gex Road, Diamondhead, MS 39525 | 2014-01-22 |
| 1760756423 | Catherine Michelle Brashear | Nurse Practitioner | 4045b Shepards Square, Diamondhead, MS 39525 | 2012-02-28 |
| 1669745303 | Christopher Byron Arcement | Nurse Practitioner | 5435 Gex Rd., Diamondhead, MS 39525 | 2012-02-10 |
| 1184894354 | Gary S. Porter | Nurse Practitioner | 4540 B Shepherds Squard, Diamondhead, MS 39525 | 2008-03-04 |
| 1003007006 | Hancock Medical Center | Clinic/Center | 4540 Shepherd Square, Suite B, Diamondhead, MS 39525 | 2007-08-05 |
| 1346461423 | Charles Eugene Harris | Psychologist | 5427-a Gex Rd, Diamondhead, MS 39525 | 2007-05-02 |
| 1548318025 | Total Rehab Plus LLC | Physical Therapist | 4363 C Leisuretime Dr, Diamondhead, MS 39525 | 2007-01-08 |
| 1356445944 | Cornelia H. Swayze | Social Worker | 4387 Leisure Time Drive, Diamondhead, MS 39525 | 2006-09-12 |
| Find all providers in zip 39525 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101378 | North Mississippi Medical Center, Inc. | Psychiatry & Neurology | 408 Council Cir Ste B, Tupelo, MS 38801-4949 | 2020-07-21 |
| 1376168500 | Ms Care Clinic, Inc | Psychiatry & Neurology | 625 S Pear Orchard Rd Ste B, Ridgeland, MS 39157-4836 | 2020-06-12 |
| 1528303401 | Dave Allen Roberts | Psychiatry & Neurology | 107 Candlewick Rd, Hattiesburg, MS 39402-3010 | 2012-12-04 |
| 1881959401 | Magnolia Specialty Clinic | Psychiatry & Neurology | 3704 Hwy. 72 West, Corinth, MS 38834-8556 | 2012-07-10 |
| 1538436167 | Mid-south Neurology-sleep Medical Clinic Pllc | Psychiatry & Neurology | 5740 Getwell Rd Bldg 6, Southaven, MS 38672-6346 | 2011-11-28 |
| 1629379078 | Bolivar Physician Practices LLC | Psychiatry & Neurology | 903 East Sunflower Rd, Suite 400, Cleveland, MS 38732-2551 | 2010-11-16 |
| 1235454059 | Mitchell Myers, M.d. | Psychiatry & Neurology | 2906 North State Street, Suite 301, Jackson, MS 39216 | 2010-04-05 |
| 1407188501 | Magnolia Regional Health Center | Psychiatry & Neurology | 611 Alcron Drive, Corinth, MS 38834 | 2010-02-01 |
| 1639309685 | Syed Baqer Sadiq | Psychiatry & Neurology | 3603 Bienville Blvd Ste 102, Ocean Springs, MS 39564-5736 | 2009-07-23 |
| 1770717449 | Precise Clinical Neuroscience Specialists | Psychiatry & Neurology | 3531 Lakeland Dr Ste 1060, Flowood, MS 39232-8016 | 2009-05-11 |
| Find all providers with the same taxonomy | ||||
| City | DIAMONDHEAD |
| Zip Code | 39525 |
Please comment or provide details below to improve the information on MEMORIAL HOSPITAL AT GULFPORT.
| 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.