MR. THOMAS WILLIAM HOLDER (NPI# 1477520666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477520666 |
| Entity Type | Individual |
| Full Name | MR. THOMAS WILLIAM HOLDER |
| Practice Address |
Medical Department, 2000 Jerry St Pe Hwy Pascagoula MS 39568-7003 |
| Mailing Address |
2147 Featherwood Dr W Atlantic Beach FL 32233-6922 |
| Practice Telephone | 2289352388 |
| Mailing Telephone | 9042707968 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2013-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
MEDICAL DEPARTMENT, 2000 JERRY ST PE HWY |
| City | PASCAGOULA |
| State | MS |
| Zip Code | 39568-7003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407488216 | Kecia Mcgowen Perkins | Physical Therapist | 75 Wisconsin Loop, Pascagoula, MS 39568 | 2020-02-10 |
| 1033234265 | William Pollock Warfield | Preventive Medicine | 1000 Jerry St. Pe' Hyw., Pascagoula, MS 39568-0149 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620887 | Porsche Ann Walley | Home Health | 5101 Orchard Ave Apt 91, Pascagoula, MS 39581-3907 | 2020-08-21 |
| 1407488216 | Kecia Mcgowen Perkins | Physical Therapist | 75 Wisconsin Loop, Pascagoula, MS 39568 | 2020-02-10 |
| 1134761786 | Cardiovascular Health Center Pllc | Internal Medicine | 4211 Hospital St Ste 202, Pascagoula, MS 39581-5310 | 2019-10-16 |
| 1508407263 | Gina A Cochran | Counselor | 1806 13th St, Pascagoula, MS 39567-6667 | 2019-10-03 |
| 1952953085 | David Jack Hale | Counselor | 4905 Telephone Rd, Pascagoula, MS 39567-1823 | 2019-07-09 |
| 1538723564 | Dwayne Patrick Bonvillain | Physical Therapist | 3615 Hospital St Ste B, Pascagoula, MS 39581-4112 | 2019-04-25 |
| 1760945448 | Jacquelyn B Ellison | Nurse Practitioner | 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 | 2019-04-10 |
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1033609581 | Reconnect Wellnes Pascagoula LLC | Preferred Provider Organization | 4211 Hospital St Ste 114, Pascagoula, MS 39581-5320 | 2018-05-10 |
| 1134628985 | Kendra S Gardner | Nurse Practitioner | 3702 Jefferson St, Pascagoula, MS 39563 | 2018-02-07 |
| Find all providers in PASCAGOULA | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235519984 | Bradley Craig Wilson | Military Health Care Provider | 2807 Montclair Ave, Pascagoula, MS 39567-5287 | 2015-06-08 |
| 1215232830 | Jessica E Shores | Military Health Care Provider | 1000 Access Rd Bldg 2026, Pascagoula, MS 39567 | 2011-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043747553 | Rowdy Pameticky | Military Health Care Provider | 952 Poni Pl, Diamondhead, MS 39525-4135 | 2017-05-15 |
| 1528515046 | Nicolas Riley | Military Health Care Provider | 5501 Marvin Shields Blvd., Gulfport, MS 39501-5007 | 2016-09-01 |
| 1477932200 | Michael Alexander Boartfield | Military Health Care Provider | 4033a Mallard Cv, Gulfport, MS 39501-2833 | 2015-05-26 |
| 1336536531 | Jeffrey Alexander Leemauk | Military Health Care Provider | 4010a Blue Heron Way, Gulfport, MS 39501-2815 | 2015-04-25 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| 1427316041 | Jeremiah John Baldwin | Military Health Care Provider | 5303 Marvin Shields Blvd, Gulfport, MS 39501-9013 | 2012-05-02 |
| 1124341763 | Trevor James Trout | Military Health Care Provider | 2603 Lower Gainesville Rd, Stennis Space Center, MS 39529-0001 | 2010-03-10 |
| 1245563162 | Jenesia Arielle Dillow Ordonia | Military Health Care Provider | 3158b Holloway Dr, Gulfport, MS 39501-9030 | 2009-09-10 |
| 1326298795 | Greg Allan Lassiter | Military Health Care Provider | 3110 B Seagull St, Gulfport, MS 39501 | 2008-09-23 |
| 1124203187 | James Sheldon Burnett | Military Health Care Provider | Nmcb 74, Unit 60243, Gulfport, MS 34099 | 2008-01-08 |
| Find all providers with the same taxonomy | ||||
| City | PASCAGOULA |
| Zip Code | 39568 |
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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.