VITREORETINAL EYE CENTER, PC (NPI# 1477603074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477603074 |
| Entity Type | Organization |
| Organization Name | VITREORETINAL EYE CENTER, PC |
| Practice Address |
962 Tommy Munro Dr. Suite B Biloxi MS 39532-2138 |
| Practice Telephone | 2283887000 |
| Practice Fax Number | 2282070522 |
| Mailing Telephone | 2283887000 |
| Mailing Fax Number | 2282070522 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2012-03-16 |
| Authorized Official Name | DR. AVIT J GREMILLION (PRESIDENT/OWNER) |
| Authorized Official Telephone | 2283887000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
023984 | LA | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
17239 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08623204 | 05 | |
| LA | LA BCBS | 438354140A | 01 |
| MS | 05109745 | 05 | |
| LA | 1486787 | 05 | |
| MS | MEDICARE RAILROAD | DE8313 | 01 |
| MS | BLUE CROSS BLUE SHIELD MS | 438354140B | 01 |
| MS | AETNA | 7812033 | 01 |
| Street Address |
962 TOMMY MUNRO DR. SUITE B |
| City | BILOXI |
| State | MS |
| Zip Code | 39532-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861479529 | Avit John Gremillion IIi | Ophthalmology | 962 Tommy Munro Dr., Suite B, Biloxi, MS 39532-2138 | 2005-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427693613 | Bloom Mental Health LLC | Nurse Practitioner | 933 Tommy Munro Dr., Suite C, Biloxi, MS 39532 | 2019-11-12 |
| 1003397530 | The National Diabetes & Obesity Research Institute At Tradition, Missi | Dietitian, Registered | 19289 St. Joseph Street, Suite C, Biloxi, MS 39532 | 2018-08-23 |
| 1134588999 | Victoria Leonard Scott | Counselor | 6905 Gregory Dr, Biloxi, MS 39532 | 2016-02-22 |
| 1639552490 | Laura O'keefe | Nurse Practitioner | 1720a Medical Park Dr Ste 150, Biloxi, MS 39532 | 2015-06-29 |
| 1659767150 | D'iberville Home Program LLC | Clinic/Center | 14215 Cook Road, Biloxi, MS 39532 | 2015-04-10 |
| 1467842476 | Alicia Michelle Mcdaniel | Nurse Practitioner | 14209 Cook Rd Suite 200, Biloxi, MS 39532 | 2015-01-28 |
| 1437402393 | Lisa Q. Brown | Occupational Therapist | 680 Bay Cove Drive, Residents At Baycove, Biloxi, MS 39532 | 2012-10-17 |
| 1962759381 | Joshua Shumway | Physical Therapist | 220 Ploesti Dr, Keesler Afb, MS 39532 | 2012-08-06 |
| 1386912483 | Polk's Crossgates Discount Drugs Inc. | Pharmacy | 1845 Popps Ferry Road, Biloxi, MS 39532 | 2011-12-05 |
| 1346566957 | Kerri Lyn Manjarrez | Social Worker | 12304 Tiffany Lane, Biloxi, MS 39532 | 2010-04-08 |
| Find all providers in zip 39532 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1790922680 | Oakview Medicine, LLC | Clinic/Center | 1721 Medical Park Dr, Suite 101, Biloxi, MS 39532-2100 | 2009-01-14 |
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| 1598911877 | George E. Wilkerson, M.d., P.a. | Clinic/Center | 348 Crossgates Blvd Ste 2300, Brandon, MS 39042-2634 | 2008-08-18 |
| 1174798334 | Don S Davis Md Pa | Clinic/Center | 5002 Hwy 39 N Bldg A, Meridian, MS 39301-1078 | 2008-04-28 |
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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.