DR BRYAN VYVERBERG MD, PLLC (NPI# 1639523277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639523277 |
| Entity Type | Organization |
| Organization Name | DR BRYAN VYVERBERG MD, PLLC |
| Practice Address |
8990 Lorraine Rd Gulfport MS 39503-4176 |
| Practice Telephone | 2283313310 |
| Practice Fax Number | 2282841608 |
| Mailing Telephone | 2283313310 |
| Mailing Fax Number | 2282841608 |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |
| Authorized Official Name | DR. BRYAN VYVERBERG (OWNER) |
| Authorized Official Telephone | 2283313310 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
22206 | MS | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
22206 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06322869 | 05 |
| Street Address |
8990 LORRAINE RD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-4176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801876545 | Jay Michael Stone | Psychologist | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2006-01-19 |
| 1437784550 | Chantal Sullivan Aprn-bc Pllc | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-03-09 |
| 1740811280 | Chantal Sullivan | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-02-03 |
| 1376010934 | Pamela Giveans Np Pllc | Clinic/Center | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2018-10-31 |
| 1467950675 | Anita Charlene Hall Aprn-bc LLC | Clinic/Center | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2018-01-23 |
| 1629582671 | Sjturner Pllc | Clinic/Center | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2017-11-29 |
| 1376057026 | Alexa Morales Lcsw LLC | Social Worker | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2017-11-16 |
| 1750802534 | Phyllis L Dickerson Lcsw | Social Worker | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2017-06-30 |
| 1720539315 | Donna Burrowes, Pllc | Psychologist | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2016-10-18 |
| 1568814812 | River Psychology Pllc | Psychologist | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2016-07-11 |
| Find all providers in the same location | ||||
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821158742 | Craig Kunins | Psychiatry & Neurology | 2840 Seabreeze Dr S, Gulfport, FL 33707-3910 | 2006-12-11 |
| 1639620560 | North Plantation | Psychiatry & Neurology | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-15 |
| 1528171469 | Pedro Antonion Munera-cordoba | Psychiatry & Neurology | 1340 Broad Ave, Ste 410, Gulfport, MS 39501 | 2006-08-16 |
| 1609883347 | Brad Z. Berger | Psychiatry & Neurology | 11150 Highway 49n, Gulfport, MS 39503 | 2006-08-02 |
| 1740272723 | Bryan Vyverberg | Psychiatry & Neurology | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649466954 | Nazmul Talukdar | Psychiatry & Neurology | 110 Patton Ave, Hattiesburg, MS 39401-6155 | 2007-09-20 |
| 1932321742 | Otis Anderson IIi | Psychiatry & Neurology | 5185 Getwell Rd, Southaven, MS 38671-9691 | 2007-05-02 |
| 1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
| 1841337656 | Cynthia Lufkin Undesser | Psychiatry & Neurology | 402 Wesley Ave, Jackson, MS 39202-1000 | 2007-01-31 |
| 1932290392 | Millcreek Epsdt | Psychiatry & Neurology | 900 First Ave., N.e., Magee, MS 39111 | 2006-09-28 |
| 1023363173 | Kelechi Nnamdi Emereonye | Psychiatry & Neurology | 4100 Mamie St, Hattiesburg, MS 39402-1735 | 2012-07-16 |
| 1710175260 | Clinical Neuroscience Group, Pllc | Psychiatry & Neurology | 3531 Lakeland Dr, Suite 1058, Flowood, MS 39232-8049 | 2007-10-10 |
| 1992906598 | Maecenas Inc | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazlehurst, MS 39083-0146 | 2007-05-30 |
| 1154477453 | Anthony Wade Jackson Sr. | Psychiatry & Neurology | 152 Highway 7 S, Oxford, MS 38655-5392 | 2007-01-27 |
| 1073684940 | Timothy Summers | Psychiatry & Neurology | 1818 College Drive, Meridian, MS 39307-5429 | 2006-11-13 |
| Find all providers with the same taxonomy | ||||
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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.