MEMORIAL HOSPITAL AT GULFPORT (NPI# 1548817117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548817117 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | MEMORIAL HOSPITAL AT STONE COUNTY |
| Practice Address |
1434 Central Ave E Wiggins MS 39577-9602 |
| Practice Telephone | 6019286600 |
| Mailing Telephone | 6019286600 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | APRIL L LAFONTAINE (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 2288653345 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Memorial Hospital at Stone County | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215354402 | Memorial Hospital At Gulfport | Physical Therapy Assistant | 2781 C.t. Switzer, Suite 404, Biloxi, MS 39531 | 2014-03-25 |
| 1609203173 | Memorial Hospital At Gulfport | Internal Medicine | 1756 Popps Ferry Rd Ste A, Biloxi, MS 39532-2118 | 2013-09-30 |
| 1285070672 | Memorial Hospital At Gulfport | Occupational Therapist | 2781 C. T. Switzer Dr., Suite 404, Biloxi, MS 39531-4535 | 2013-05-13 |
| 1205129137 | Memorial Hospital At Gulfport | Family Medicine | 20006 Hwy 53, 7 Sunshine Place, Gulfport, MS 39503-0000 | 2011-05-25 |
| 1275848889 | Memorial Hospital At Gulfport | Internal Medicine | 4405 E Aloha Dr, Suite 1, Diamondhead, MS 39525-3380 | 2010-08-09 |
| 1649585258 | Memorial Hospital At Gulfport | Internal Medicine | 784 Vieux Marche Mall, Biloxi, MS 39530-3822 | 2010-08-09 |
| 1730411463 | Memorial Hospital At Gulfport | Pediatrics | 12259 Highway 49, Suite C, Gulfport, MS 39503-3063 | 2010-02-05 |
| 1649404435 | Memorial Hospital At Gulfport | Internal Medicine | 970 Tommy Munro Dr, Biloxi, MS 39532-2130 | 2009-05-07 |
| 1295978435 | Memorial Hospital At Gulfport | Psychiatry & Neurology | 5407 Indian Hill Blvd, Diamondhead, MS 39525-3324 | 2009-04-17 |
| 1255524211 | Memorial Hospital At Gulfport | Clinic/Center | 1340 Broad Ave Ste 220, Gulfport, MS 39501-2404 | 2007-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| Street Address |
1434 CENTRAL AVE E |
| City | WIGGINS |
| State | MS |
| Zip Code | 39577-9602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386654309 | Stone County Hospital, Inc. | General Acute Care Hospital | 1434 Central Ave E, P O Drawer 97, Wiggins, MS 39577-9602 | 2006-08-09 |
| 1427687060 | Autrionne D Monroe | Speech-Language Pathologist | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2020-04-06 |
| 1134779200 | Memorial Hospital At Gulfport | Ambulance | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2019-09-19 |
| 1114481488 | Hannah Leigh Fore | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2019-01-30 |
| 1386125383 | Kendra Iesha Samuel | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2018-08-27 |
| 1891223186 | Christine L Ladner | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577 | 2017-05-31 |
| 1013452473 | Evelyn Perreault Rutledge | Social Worker | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2016-12-21 |
| 1225488281 | La'toria Evans | Physical Therapy Assistant | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2016-06-20 |
| 1437413770 | Joshua Carmi Alderman IIi | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2012-07-02 |
| 1033340690 | James Jason Rogers | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2009-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1235468190 | Stone County School District | Local Education Agency (LEA) | 214 Critz Street, Wiggins, MS 39577 | 2009-12-23 |
| 1043452493 | Stone County Hospital, Inc | General Acute Care Hospital | 1434 E Central Ave., Wiggins, MS 39577 | 2009-04-01 |
| 1245274414 | James Walter Holmes | Family Medicine | 975 Hall Street, Wiggins, MS 39577 | 2006-06-16 |
| 1790962637 | The Vision Center Pa | Optometrist | 1113 Central Ave E, Wiggins, MS 39577 | 2008-01-23 |
| 1821009465 | County Discount Drugs, Inc. | Durable Medical Equipment & Medical Supplies | 820 Hall St, Wiggins, MS 39577-2100 | 2006-08-10 |
| 1154430940 | Batson Physical Therapy, Inc. | Clinic/Center | 711 Hall St, Wiggins, MS 39577-2105 | 2006-08-29 |
| 1033723937 | Katherine B Tyree | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2020-09-08 |
| 1114569340 | Johelen K Trisler | Physical Therapy Assistant | 711 Hall St, Wiggins, MS 39577-2105 | 2019-10-09 |
| 1720502586 | Sheila S Carney | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2017-08-02 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1013396290 | Martin Hillard Mcmullan | General Acute Care Hospital | 2350 Cooper Rd, Flowood, MS 39232-6136 | 2015-05-21 |
| 1750771580 | Genesis Rehab | General Acute Care Hospital | 438 North St, Union, MS 39365-9506 | 2015-02-02 |
| 1003229469 | Robert J Cole | General Acute Care Hospital | 601 Meadowbrook Cir, Amory, MS 38821-1314 | 2014-06-03 |
| 1295151850 | Mary A. Doss | General Acute Care Hospital | 110 Napoleon Dr, Brandon, MS 39047-9004 | 2014-03-06 |
| 1467755744 | Biloxi Regional Medical Center | General Acute Care Hospital | 1104 Homestead Blvd, Gautier, MS 39553-4612 | 2010-12-08 |
| 1528371119 | University Physicians. Pllc | General Acute Care Hospital | 121 Beaufort Cir, Madison, MS 39110-7962 | 2010-07-23 |
| 1306047436 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy4-east, Holly Springs, MS 38635 | 2007-05-29 |
| 1518168624 | Alliance Healthcare System | General Acute Care Hospital | 1430 Hwy 4 East, Holly Springs, MS 38635 | 2007-05-29 |
| 1043427206 | Alliance Healthcare System, Inc | General Acute Care Hospital | 1430 Highway 4 E, Holly Springs, MS 38635-2140 | 2007-05-17 |
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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.