MEMORIAL HOSPITAL (NPI# 1417029828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417029828 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL |
| Other Organization Name | PHYSICAL MEDICINE & REHAB |
| Practice Address |
4500 13th St Gulfport MS 39501-2515 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2288674046 |
| Mailing Telephone | 2288677404 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2008-12-11 |
| Authorized Official Name | MR. KENT NICAUD (ADMINISTRATOR) |
| Authorized Official Telephone | 2288674046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RAILROAD MEDICARE | CA1177 | 01 |
| MS | 09014910 | 05 |
| Other Name | Type Code |
|---|---|
| Physical Medicine & Rehab | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528447992 | Memorial Hospital | General Acute Care Hospital | 1400 E. Boulder St. #3138, Colorado Springs, CO 80045 | 2015-05-19 |
| 1629469002 | Memorial Hospital | Family Medicine | 2319 Old Plank Road, Chester, IL 62233-1116 | 2015-02-06 |
| 1609073709 | Memorial Hospital | Nurse Practitioner | 9099 E Lansing Rd Ste B, Durand, MI 48429-1083 | 2007-07-02 |
| 1003025883 | Memorial Hospital | Psychiatric Residential Treatment Facility | 806 Central Ave Se, Albuquerque, NM 87102-3606 | 2007-05-21 |
| 1376759563 | Memorial Hospital | Family Medicine | 86 Savannah Lane, Bulan, KY 41722 | 2007-05-15 |
| 1598977787 | Memorial Hospital | Family Medicine | 3337 W Britton Rd, Perry, MI 48872 | 2007-05-03 |
| 1639209232 | Memorial Hospital | Internal Medicine | 1480 N M 52, Owosso, MI 48867-1235 | 2007-03-06 |
| 1306973805 | Memorial Hospital | Physician Assistant | 207 Shirlwood Dr, Schenectady, NY 12306-3417 | 2007-02-28 |
| 1851338149 | Memorial Hospital | General Acute Care Hospital | 715 South Taft Avenue, Fremont, OH 43420-3200 | 2006-06-02 |
| 1316923485 | Memorial Hospital | Hospice Care, Community Based | 1412 6th Ave, York, PA 17403-2648 | 2005-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL | 224 E 2nd St, Dumas, TX 79029-3808 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL & HEALTH CARE CENTER | 800 W 9th St, Jasper, IN 47546-2514 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND COMMUNITY HEALTH FOUNDATION INC | 112 East Fifth Avenue, Antigo, WI 54409-2710 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND HOMES ASSOCIATION, INC. | 415 8th Ave Sw, Perham, MN 56573-1156 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MANOR | 1500 E Shotwell St, Bainbridge, GA 39819-4256 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MEDICAL CENTER | 400 Rosalind Redfern Grover Parkway, Midland, TX 79701-5846 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL CENTRAL | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL EAST | 1404 Cross St, Shiloh, IL 62269-2988 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL FOR CANCER & ALLIED DISEASES | 1275 York Ave, New York, NY 10065-6007 |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| Find all providers in the same location | ||||
| 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 | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730304585 | Horrell H Townsend IIi | Physical Medicine & Rehabilitation | 11010 David St, Suite B, Gulfport, MS 39503-3481 | 2007-04-16 |
| 1952462905 | Shawn X Wu | Physical Medicine & Rehabilitation | 14986 Angela Dr, Gulfport, MS 39503-3502 | 2006-12-13 |
| 1780772871 | Elizabeth Z Bozlee | Physical Medicine & Rehabilitation | 14478 Aerie Rd, Gulfport, MS 39503 | 2006-10-11 |
| 1619142718 | Ramakrishna Rao Settipalli | Physical Medicine & Rehabilitation | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2008-04-29 |
| 1962474601 | Joseph Anthony Lanni | Physical Medicine & Rehabilitation | 1340 Broad Ave, Suite 440, Gulfport, MS 39501-2418 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497367494 | Adrianna Carpenter | Physical Medicine & Rehabilitation | 1020 River Oaks Dr Ste 112, Flowood, MS 39232-9511 | 2020-08-20 |
| 1700348133 | Collaborative Health and Rehabilitation Services, Inc | Physical Medicine & Rehabilitation | 1068 Buck Cir, Summit, MS 39666-9723 | 2019-04-04 |
| 1790275956 | Gulf Coast Wellness Center Inc | Physical Medicine & Rehabilitation | 2318 Pass Rd Ste 7c, Biloxi, MS 39531 | 2018-05-14 |
| 1750882080 | Hattiesburg Clinic, Pa | Physical Medicine & Rehabilitation | 2 Southern Point Pkwy Ste 200, Hattiesburg, MS 39401-8025 | 2018-02-22 |
| 1740500958 | Joshua Eric Tucker | Physical Medicine & Rehabilitation | 4105 Hospital St Ste 112b, Pascagoula, MS 39581 | 2010-06-10 |
| 1073746152 | Interventional Spine & Sports Institute | Physical Medicine & Rehabilitation | 105 Asbury Cir Ste B, Hattiesburg, MS 39402-1397 | 2009-08-24 |
| 1790909067 | Laura Ann Gray | Physical Medicine & Rehabilitation | 905 Garfield St, Tupelo, MS 38801-5737 | 2007-04-11 |
| 1689762288 | Jeanette Zurawski | Physical Medicine & Rehabilitation | 637 W Main St, Tupelo, MS 38804-3732 | 2006-10-10 |
| 1770694655 | John R Tait | Physical Medicine & Rehabilitation | 705 N Lamar Blvd, Oxford, MS 38655-3242 | 2006-08-31 |
| 1487664173 | Jo Lynn Polk | Physical Medicine & Rehabilitation | 4798 Mcwillie Dr, Suite C, Jackson, MS 39206-5608 | 2006-08-08 |
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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.