AMY M DIMITRIADES (NPI# 1396065694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396065694 |
| Entity Type | Individual |
| Full Name | AMY M DIMITRIADES |
| Credential | NP-C |
| Practice Address |
4540 W Railroad St Gulfport MS 39501-2480 |
| Mailing Address |
Po Box 1810 Gulfport MS 39502-1810 |
| Practice Telephone | 2288676062 |
| Practice Fax Number | 2288672598 |
| Mailing Telephone | 2288651330 |
| Mailing Fax Number | 2288651331 |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2014-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R859046 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4540 W RAILROAD ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588617997 | Beverly Lansden | Internal Medicine | 4540 W Railroad St, Gulfport, MS 39501-2480 | 2006-05-18 |
| 1013254358 | Ashley Barq House | Nurse Practitioner | 4540 W Railroad St, Gulfport, MS 39501-2480 | 2013-01-07 |
| 1366774093 | Memorial Hospital At Gulfport | Internal Medicine | 4540 W Railroad St, Suite B, Gulfport, MS 39501-2480 | 2010-02-05 |
| 1801128533 | Memorial Hospital At Gulfport | Internal Medicine | 4540 W Railroad St, Suite A, Gulfport, MS 39501-2480 | 2010-02-05 |
| 1790973071 | Memorial Hospital At Gulfport | Internal Medicine | 4540 W Railroad St, Gulfport, MS 39501-2480 | 2007-10-11 |
| 1043434566 | Gulf Coast Endocrinology | Internal Medicine | 4540 W Railroad St, Gulfport, MS 39501-2480 | 2007-04-13 |
| 1912950320 | Muzaffar Piracha | Internal Medicine | 4540 W Railroad St, Gulfport, MS 39501-2480 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1063033108 | Tiffany Reffit | Nurse Practitioner | 4300 15th St Ste B, Gulfport, MS 39501-2524 | 2020-04-29 |
| 1669002333 | Lauren Renee Meaut | Nurse Practitioner | 1391 Broad Ave Ste 320, Gulfport, MS 39501-2419 | 2020-01-22 |
| 1871132076 | Meddol Regina Mccray | Nurse Practitioner | 2070 30th St, Gulfport, MS 39501-6055 | 2020-01-06 |
| 1154968394 | Carolyn Marie Peters | Nurse Practitioner | 10236 Little Gem Dr, Gulfport, MS 39503-8357 | 2019-12-06 |
| 1588121578 | Mai Thi Tran | Nurse Practitioner | 1404 44th Ave, Gulfport, MS 39501-2554 | 2019-02-26 |
| 1861957631 | Tomika Marie Dedeaux | Nurse Practitioner | 283 Debuys Rd, Gulfport, MS 39507-2800 | 2019-02-06 |
| 1861963993 | Carol Leigh Anne Thompson | Nurse Practitioner | 2449 Summerwood, Gulfport, MS 39507-2216 | 2018-12-16 |
| 1730679739 | Erica Lynn Turan | Nurse Practitioner | 3310 17th St, Gulfport, MS 39501-3915 | 2018-05-15 |
| 1740709773 | Justine Hunt | Nurse Practitioner | 8950 Lorraine Rd Ste B, Gulfport, MS 39503-4183 | 2017-09-11 |
| 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.