GULF COAST MENTAL HEALTH CENTER (NPI# 1548765670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548765670 |
| Entity Type | Organization |
| Organization Name | GULF COAST MENTAL HEALTH CENTER |
| Practice Address |
1600 Broad Avenue Gulfport MS 39501 |
| Practice Telephone | 2288631132 |
| Practice Fax Number | 2288651700 |
| Mailing Telephone | 2288631132 |
| Mailing Fax Number | 2288651700 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |
| Authorized Official Name | MANDY JO MCDONALD (BILLING SUPERVISOR) |
| Authorized Official Telephone | 2288631132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
M8456 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1124520549 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 819b Central Ave, Bay St Louis, MS 39520-3913 | 2018-03-01 |
| 1598127771 | Gulf Coast Mental Health Center | Psychologist | 1110 42nd Ave, Gulfport, MS 39501-2663 | 2016-03-25 |
| 1417934175 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2005-12-23 |
| 1962995860 | Gulf Coast Mental Health Center | Community/Behavioral Health | 15094 County Barn Road, Gulfport, MS 39503 | 2018-06-14 |
| 1467956037 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-20 |
| 1821591728 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1649773540 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1386057628 | Gulf Coast Mental Health Center | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2014-06-04 |
| 1861715773 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2010-03-05 |
| Street Address |
1600 BROAD AVENUE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316176126 | Debra Lynne Deas | Social Worker | 1600 Broad Avenue, Gulfport, MS 39501-3606 | 2009-07-14 |
| 1467956037 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-20 |
| 1821591728 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1649773540 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1205350410 | Cynthia Lynette Johnson | Nurse Practitioner | 1600 Broad Avenue, Gulfport, MS 39501 | 2017-07-29 |
| 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 | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538723564 | Dwayne Patrick Bonvillain | Physical Therapist | 3615 Hospital St Ste B, Pascagoula, MS 39581-4112 | 2019-04-25 |
| 1265746309 | Physical Therapy Professionals | Physical Therapist | 2900 Melton Ave, Pascagoula, MS 39581-4120 | 2010-07-30 |
| 1598085730 | Lisa A Weathers | Physical Therapist | 1707 S Colorado St, Suite A, Greenville, MS 38703-7275 | 2010-06-10 |
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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.