MEMORIAL HOSPITAL AT GULFPORT (NPI# 1649404435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649404435 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | MEMORIAL PHYSICIANS CLINIC @CEDAR LAKE |
| Practice Address |
970 Tommy Munro Dr Biloxi MS 39532-2130 |
| Mailing Address |
1612 31st Ave Gulfport MS 39501-2750 |
| Practice Telephone | 2283883820 |
| Practice Fax Number | 2283883382 |
| Mailing Telephone | 2288651453 |
| Mailing Fax Number | 2288651457 |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-07-10 |
| Authorized Official Name | JEFF STEINER (VP FINANCE) |
| Authorized Official Telephone | 2288653469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07007871 | 05 |
| Other Name | Type Code |
|---|---|
| MEMORIAL PHYSICIANS CLINIC @CEDAR LAKE | 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 |
| 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 |
| 1053535781 | Memorial Hospital At Gulfport | Clinic/Center | 12057 Highway 49 Ste C, Gulfport, MS 39503-3177 | 2007-04-12 |
| 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 |
970 TOMMY MUNRO DR |
| City | BILOXI |
| State | MS |
| Zip Code | 39532-2130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164972170 | Hattiesburg Clinic Pa | Internal Medicine | 970 Tommy Munro Dr, Suite B, Biloxi, MS 39532-2175 | 2016-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427693613 | Bloom Mental Health LLC | Nurse Practitioner | 933 Tommy Munro Dr., Suite C, Biloxi, MS 39532 | 2019-11-12 |
| 1003397530 | The National Diabetes & Obesity Research Institute At Tradition, Missi | Dietitian, Registered | 19289 St. Joseph Street, Suite C, Biloxi, MS 39532 | 2018-08-23 |
| 1134588999 | Victoria Leonard Scott | Counselor | 6905 Gregory Dr, Biloxi, MS 39532 | 2016-02-22 |
| 1639552490 | Laura O'keefe | Nurse Practitioner | 1720a Medical Park Dr Ste 150, Biloxi, MS 39532 | 2015-06-29 |
| 1659767150 | D'iberville Home Program LLC | Clinic/Center | 14215 Cook Road, Biloxi, MS 39532 | 2015-04-10 |
| 1467842476 | Alicia Michelle Mcdaniel | Nurse Practitioner | 14209 Cook Rd Suite 200, Biloxi, MS 39532 | 2015-01-28 |
| 1437402393 | Lisa Q. Brown | Occupational Therapist | 680 Bay Cove Drive, Residents At Baycove, Biloxi, MS 39532 | 2012-10-17 |
| 1962759381 | Joshua Shumway | Physical Therapist | 220 Ploesti Dr, Keesler Afb, MS 39532 | 2012-08-06 |
| 1386912483 | Polk's Crossgates Discount Drugs Inc. | Pharmacy | 1845 Popps Ferry Road, Biloxi, MS 39532 | 2011-12-05 |
| 1346566957 | Kerri Lyn Manjarrez | Social Worker | 12304 Tiffany Lane, Biloxi, MS 39532 | 2010-04-08 |
| Find all providers in zip 39532 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205390549 | Coast Neurology and Wellness Clinic LLC | Psychiatry & Neurology | 1903 Pass Rd Ste A, Biloxi, MS 39531-4120 | 2019-01-30 |
| 1407154438 | Biloxi Hma Physician Management, LLC | Psychiatry & Neurology | 147 Reynoir St, Suite 304, Biloxi, MS 39530-4109 | 2011-02-28 |
| 1427170885 | Gulf Coast Neurology Clinic, P.a. | Psychiatry & Neurology | 147 Reynoir St, Ste 304, Biloxi, MS 39530-4109 | 2007-04-05 |
| 1407966567 | Vasanthi Kumari Nalluri | Psychiatry & Neurology | 400 Veterans Avenue, Biloxi, MS 39531 | 2006-08-30 |
| 1881602100 | Susan Boston | Psychiatry & Neurology | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101378 | North Mississippi Medical Center, Inc. | Psychiatry & Neurology | 408 Council Cir Ste B, Tupelo, MS 38801-4949 | 2020-07-21 |
| 1376168500 | Ms Care Clinic, Inc | Psychiatry & Neurology | 625 S Pear Orchard Rd Ste B, Ridgeland, MS 39157-4836 | 2020-06-12 |
| 1528303401 | Dave Allen Roberts | Psychiatry & Neurology | 107 Candlewick Rd, Hattiesburg, MS 39402-3010 | 2012-12-04 |
| 1881959401 | Magnolia Specialty Clinic | Psychiatry & Neurology | 3704 Hwy. 72 West, Corinth, MS 38834-8556 | 2012-07-10 |
| 1538436167 | Mid-south Neurology-sleep Medical Clinic Pllc | Psychiatry & Neurology | 5740 Getwell Rd Bldg 6, Southaven, MS 38672-6346 | 2011-11-28 |
| 1629379078 | Bolivar Physician Practices LLC | Psychiatry & Neurology | 903 East Sunflower Rd, Suite 400, Cleveland, MS 38732-2551 | 2010-11-16 |
| 1235454059 | Mitchell Myers, M.d. | Psychiatry & Neurology | 2906 North State Street, Suite 301, Jackson, MS 39216 | 2010-04-05 |
| 1407188501 | Magnolia Regional Health Center | Psychiatry & Neurology | 611 Alcron Drive, Corinth, MS 38834 | 2010-02-01 |
| 1639309685 | Syed Baqer Sadiq | Psychiatry & Neurology | 3603 Bienville Blvd Ste 102, Ocean Springs, MS 39564-5736 | 2009-07-23 |
| 1770717449 | Precise Clinical Neuroscience Specialists | Psychiatry & Neurology | 3531 Lakeland Dr Ste 1060, Flowood, MS 39232-8016 | 2009-05-11 |
| 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.