MEMORIAL HOSPITAL AT GULFPORT (NPI# 1346677812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346677812 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Practice Address |
4300 Leisure Time Dr Suite A Diamondhead MS 39525-3241 |
| Mailing Address |
Po Box 1810 Gulfport MS 39502-1810 |
| Practice Telephone | 2282554300 |
| Practice Fax Number | 2282553626 |
| Mailing Telephone | 2285751700 |
| Mailing Fax Number | 2285751735 |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |
| Authorized Official Name | JEFFREY T STEINER (VP OF FINANCE) |
| Authorized Official Telephone | 2288653106 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| 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 |
4300 LEISURE TIME DR SUITE A |
| City | DIAMONDHEAD |
| State | MS |
| Zip Code | 39525-3241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932118965 | David F Roberts | Family Medicine | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2006-08-07 |
| 1932410594 | Mmemorial Hospital At Gulfport | Family Medicine | 4300 Leisure Time Dr, Suite A, Diamondhead, MS 39525-3241 | 2010-06-29 |
| 1972835619 | Memorial Hospital At Gulfport | Internal Medicine | 4300 Leisure Time Dr, Suite B, Diamondhead, MS 39525-3241 | 2010-02-05 |
| 1134377187 | Barbara Denise Franceski | Nurse Practitioner | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2008-09-03 |
| 1649341256 | Ann Reed | Nurse Practitioner | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2006-11-13 |
| 1285741215 | Barbara R Higgins | Nurse Practitioner | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2006-08-24 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336378819 | Amber Hope Mcilwain | Family Medicine | 4540 Shepherd Sq, Diamondhead, MS 39525-3325 | 2009-07-06 |
| 1770620403 | David F. Roberts, Md | Family Medicine | 5435 Gex Rd, Diamondhead, MS 39525-3208 | 2007-01-31 |
| 1508942137 | Erin Adam Dewitt | Family Medicine | 4405 E Aloha Dr Bldg 1a, Diamondhead, MS 39525-3388 | 2006-10-27 |
| 1184732448 | Hancock Family Medicine | Family Medicine | 5400 Indian Hill Blvd, Diamondhead, MS 39525-3334 | 2006-08-28 |
| 1932118965 | David F Roberts | Family Medicine | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2006-08-07 |
| 1568423697 | Bita Ghaffari | Family Medicine | 4433 Leisure Time Dr., Diamondhead, MS 39525-3334 | 2006-03-29 |
| 1679543102 | Ronald Fulton Kellum | Family Medicine | 4433 Leisure Time, Diamondhead, MS 39525-3259 | 2006-01-26 |
| 1700264025 | Gulf Coast Life, Pllc | Family Medicine | 4405 E Aloha Dr, Diamondhead, MS 39525-3380 | 2015-05-07 |
| 1730425802 | Hancock Medical Health Services, Inc. | Family Medicine | 4433 Leisure Time Dr., Diamondhead, MS 39525 | 2012-12-18 |
| 1932410594 | Mmemorial Hospital At Gulfport | Family Medicine | 4300 Leisure Time Dr, Suite A, Diamondhead, MS 39525-3241 | 2010-06-29 |
| Find all providers in DIAMONDHEAD | ||||
| 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.