MEMORIAL HOSPITAL AT GULFPORT (NPI# 1568793859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568793859 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | SOUTHERN COAST FAMILY MEDICAL @ MHG |
| Practice Address |
12261 Highway 49 Suite 11 Gulfport MS 39503-2975 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2288675185 |
| Practice Fax Number | 2288675189 |
| Mailing Telephone | 2288651453 |
| Mailing Fax Number | 2288651457 |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |
| Authorized Official Name | RANDY ROBINSON (DIRECTOR) |
| Authorized Official Telephone | 2288651453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03439000 | 05 |
| Other Name | Type Code |
|---|---|
| SOUTHERN COAST FAMILY MEDICAL @ MHG | 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 |
12261 HIGHWAY 49 SUITE 11 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-2975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730268939 | Sean C Kerby | Family Medicine | 12261 Highway 49, Suite 11, Gulfport, MS 39503-2975 | 2006-11-06 |
| 1881134740 | Gulfport Wellness Center Inc | Clinic/Center | 12261 Highway 49, Suite 6, Gulfport, MS 39503-2975 | 2017-02-26 |
| 1003153966 | Brittany Nicole Coleman | Nurse Practitioner | 12261 Highway 49, Suite 11, Gulfport, MS 39503-2975 | 2013-01-12 |
| 1609158260 | Delphine K. Shannon | General Practice | 12261 Highway 49, Suite 6, Gulfport, MS 39503-2975 | 2011-09-09 |
| 1720368855 | Madelena Campbell | Registered Nurse | 12261 Highway 49, Suite 11, Gulfport, MS 39503-2975 | 2011-08-20 |
| 1043542772 | Memorial Hospital At Gulfport | Family Medicine | 12261 Highway 49, Suite 11 F, Gulfport, MS 39503-2975 | 2010-02-05 |
| 1225294010 | Memorial Hospital At Gulfport | Allergy & Immunology | 12261 Highway 49, Gulfport, MS 39503-2975 | 2008-08-01 |
| 1326264953 | Barbara L. Kerby | Nurse Practitioner | 12261 Highway 49, Ste 11, Gulfport, MS 39503-2975 | 2007-04-18 |
| 1295898724 | Nyron T Marshall | Internal Medicine | 12261 Highway 49, Suite 11, Gulfport, MS 39503-2975 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 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 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235787185 | Integrated Medical and Wellness Clinic of Mississippi LLC | Family Medicine | 2160 E Pass Rd Ste 102, Gulfport, MS 39507-3801 | 2019-09-03 |
| 1366952921 | George W Monlux Jr Md Inc | Family Medicine | 4602 27th Ave S, Gulfport, FL 33711-3704 | 2017-10-09 |
| 1790071371 | Joan Marie Gonzalez | Family Medicine | 5501 Marvin Shields Blvd Bldg 295, Gulfport, MS 39501-9007 | 2011-06-22 |
| 1205129137 | Memorial Hospital At Gulfport | Family Medicine | 20006 Hwy 53, 7 Sunshine Place, Gulfport, MS 39503-0000 | 2011-05-25 |
| 1295934115 | Candace Worsham | Family Medicine | 1924 30th Ave, Gulfport, MS 39501-4534 | 2007-07-11 |
| 1982735510 | George Cornelius Moench | Family Medicine | 5702 Gulfport Blvd S, Suite 4, Gulfport, FL 33707-4855 | 2007-03-07 |
| 1730245739 | Paul G Matherne | Family Medicine | 1924 E Pass Rd, Gulfport, MS 39507-3715 | 2006-12-28 |
| 1780755173 | Roger H Reed | Family Medicine | 15444 Dedeaux Rd, Ste. B, Gulfport, MS 39503-2637 | 2006-11-10 |
| 1730268939 | Sean C Kerby | Family Medicine | 12261 Highway 49, Suite 11, Gulfport, MS 39503-2975 | 2006-11-06 |
| 1740365055 | Francisco Camero | Family Medicine | 1202 Broad Ave, Gulfport, MS 39501-2426 | 2006-10-26 |
| Find all providers in GULFPORT | ||||
Please comment or provide details below to improve the information on MEMORIAL HOSPITAL AT GULFPORT.
| 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.