MICHAEL D HAGGERTY JR. (NPI# 1538367123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538367123 |
| Entity Type | Individual |
| Full Name | MICHAEL D HAGGERTY JR. |
| Credential | IDC |
| Practice Address |
1049 Bayou Pl Diamondhead MS 39525-4108 |
| Practice Telephone | 2288712810 |
| Practice Fax Number | 2288713725 |
| Mailing Telephone | 2288712810 |
| Mailing Fax Number | 2288713725 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992808794 | Michael Haggerty | Obstetrics & Gynecology | 5533 Mahoning Ave, Suite D, Youngstown, OH 44515-2366 | 2006-09-07 |
| 1720087323 | Michael F Haggerty | Radiology | 10500 Montgomery Rd, Cincinnati, OH 45242-4402 | 2005-07-18 |
| Street Address |
1049 BAYOU PL |
| City | DIAMONDHEAD |
| State | MS |
| Zip Code | 39525-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447762042 | South Mississippi Home Care, LLC | Home Health | 56128 Diamondhead Dr E, Diamondhead, MS 39525 | 2017-11-04 |
| 1093247553 | Deedy Killen | Registered Nurse | 124a Lakeside Villa Bldg C, Diamondhead, MS 39525 | 2017-04-03 |
| 1730502055 | Hancock Medical Health Services | Clinic/Center | 5435 Gex Road, Diamondhead, MS 39525 | 2014-01-22 |
| 1760756423 | Catherine Michelle Brashear | Nurse Practitioner | 4045b Shepards Square, Diamondhead, MS 39525 | 2012-02-28 |
| 1669745303 | Christopher Byron Arcement | Nurse Practitioner | 5435 Gex Rd., Diamondhead, MS 39525 | 2012-02-10 |
| 1184894354 | Gary S. Porter | Nurse Practitioner | 4540 B Shepherds Squard, Diamondhead, MS 39525 | 2008-03-04 |
| 1003007006 | Hancock Medical Center | Clinic/Center | 4540 Shepherd Square, Suite B, Diamondhead, MS 39525 | 2007-08-05 |
| 1346461423 | Charles Eugene Harris | Psychologist | 5427-a Gex Rd, Diamondhead, MS 39525 | 2007-05-02 |
| 1548318025 | Total Rehab Plus LLC | Physical Therapist | 4363 C Leisuretime Dr, Diamondhead, MS 39525 | 2007-01-08 |
| 1356445944 | Cornelia H. Swayze | Social Worker | 4387 Leisure Time Drive, Diamondhead, MS 39525 | 2006-09-12 |
| Find all providers in zip 39525 | ||||
| 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 |
|---|---|---|---|---|
| 1043747553 | Rowdy Pameticky | Military Health Care Provider | 952 Poni Pl, Diamondhead, MS 39525-4135 | 2017-05-15 |
| 1831395540 | Beverly Jean Malm | Military Health Care Provider | 8816 Manoo St, Diamondhead, MS 39525-4221 | 2007-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528515046 | Nicolas Riley | Military Health Care Provider | 5501 Marvin Shields Blvd., Gulfport, MS 39501-5007 | 2016-09-01 |
| 1235519984 | Bradley Craig Wilson | Military Health Care Provider | 2807 Montclair Ave, Pascagoula, MS 39567-5287 | 2015-06-08 |
| 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 |
| 1215232830 | Jessica E Shores | Military Health Care Provider | 1000 Access Rd Bldg 2026, Pascagoula, MS 39567 | 2011-01-12 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | DIAMONDHEAD |
| Zip Code | 39525 |
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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.