DR. BRYAN VYVERBERG (NPI# 1740272723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740272723 |
| Entity Type | Individual |
| Full Name | DR. BRYAN VYVERBERG |
| Credential | M.D. |
| Practice Address |
15190 Community Rd Suite 260 Gulfport MS 39503-3485 |
| Practice Telephone | 2283313310 |
| Mailing Telephone | 2283313310 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2015-02-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
22206 | MS | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
10017 | HI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06322869 | 05 |
| Street Address |
15190 COMMUNITY RD SUITE 260 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337770 | Ronald David Evans | Surgery | 15190 Community Rd, Suite 250, Gulfport, MS 39503-3485 | 2005-06-21 |
| 1861010159 | Singing River Gulfport | Clinic/Center | 15190 Community Rd, Gulfport, MS 39503-3485 | 2020-07-13 |
| 1427594480 | Christina Barnes | Nurse Practitioner | 15190 Community Rd, Suite 110, Gulfport, MS 39503-3485 | 2017-01-16 |
| 1417400896 | David N Johnston Jr. | Nurse Anesthetist, Certified Registered | 15190 Community Rd, Gulfport, MS 39503-3485 | 2016-08-02 |
| 1023469244 | Michelle Wright Taylor | Nurse Practitioner | 15190 Community Rd, Ste 220, Gulfport, MS 39503-3485 | 2016-06-29 |
| 1396107330 | D Balder Md, Pllc | Specialist | 15190 Community Rd, Gulfport, MS 39503-3485 | 2016-03-28 |
| 1154725562 | Matthew James Ladner | Physical Therapy Assistant | 15190 Community Rd, Gulfport, MS 39503-3485 | 2014-10-14 |
| 1255770558 | Amy Lynn Scheller | Surgery | 15190 Community Rd, Gulfport, MS 39503-3485 | 2013-06-19 |
| 1003254525 | Philip D Myers | Orthopaedic Surgery | 15190 Community Rd, Gulfport, MS 39503 | 2013-06-06 |
| 1508202268 | Jeremy W Owens, Md, PC | Psychiatry & Neurology | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2013-05-21 |
| 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 |
| 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 |
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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.