PATRIOT HEALTHCARE OF MISSISSIPPI, LLC (NPI# 1477022838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477022838 |
| Entity Type | Organization |
| Organization Name | PATRIOT HEALTHCARE OF MISSISSIPPI, LLC |
| Practice Address |
1110 Broad Street Suite 300 Gulfport MS 39501 |
| Mailing Address |
100 Arricola Avenue St. Augustine FL 32080 |
| Practice Telephone | 2285634787 |
| Mailing Telephone | 9048254368 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |
| Authorized Official Name | DAVID A. CULVER (ADMINISTRATOR) |
| Authorized Official Telephone | 9048254368 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PHC of MS Gulfport | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1467921825 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 2781 C T Switzer Sr Drive, Suite 308, Biloxi, MS 39531 | 2018-11-15 |
| Street Address |
1110 BROAD STREET SUITE 300 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501 |
| 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 |
| 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 |
| 1063781086 | Harbor View Oral and Facial Surgery LLC | Dentist | 1301 25th Avenue, Suite 3, Gulfport, MS 39501 | 2011-12-20 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255447900 | Donald D. Weaver | Family Medicine | 1612 31st Ave, Gulfport, MS 39501-2750 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1467921825 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 2781 C T Switzer Sr Drive, Suite 308, Biloxi, MS 39531 | 2018-11-15 |
| 1295224954 | Flora Physicians, Pllc | Family Medicine | 4848 Main St, Flora, MS 39071-9515 | 2018-05-08 |
| 1265803985 | Mississippi Phs Md LLC | Family Medicine | 232 Market St, Flowood, MS 39232-3339 | 2015-10-08 |
| 1609187152 | Rebecca E Hollingsworth | Family Medicine | 20 Rawls Springs Loop Rd, Hattiesburg, MS 39402-7801 | 2010-06-30 |
| 1104076645 | Ashley Wayne Harris | Family Medicine | 845 S Madison St, Tupelo, MS 38801-4905 | 2008-09-20 |
| 1659388585 | John Phenis Hey IIi | Family Medicine | 405 River Rd, Greenwood, MS 38930-4212 | 2006-08-02 |
| 1841206760 | Robert H Pierce | Family Medicine | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2006-07-31 |
| 1124048756 | Cherie Diane Knight | Family Medicine | 400 Veterans Ave, 11e, Biloxi, MS 39531-2410 | 2006-07-19 |
| 1124010640 | Gary G. Gordon | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2005-08-19 |
| 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.