MEMORIAL HOSPITAL AT GULFPORT (NPI# 1801905310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801905310 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | DRIFTWOOD NURSING CENTER |
| Practice Address |
1500 Broad Ave Gulfport MS 39501-3601 |
| Practice Telephone | 2288681314 |
| Practice Fax Number | 2288638966 |
| Mailing Telephone | 2288681314 |
| Mailing Fax Number | 2288638966 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-07-05 |
| Authorized Official Name | MR. KENT NICAUD (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2288679501 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 193 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0230135 | 05 |
| Other Name | Type Code |
|---|---|
| Driftwood Nursing Center | 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 |
1500 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386106094 | Grady Consulting Services, LLC | Internal Medicine | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2019-04-02 |
| 1952884652 | Primesource Nursing Services, Inc | Social Worker | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2018-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333629 | Pensacola Health Trust Inc | Skilled Nursing Facility | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2005-08-22 |
| 1720082688 | Boca Ciega Rehabilitation Center, LLC | Skilled Nursing Facility | 1414 59th St S, Gulfport, FL 33707-3352 | 2005-06-09 |
| 1720081052 | Lakeview Corporation | Skilled Nursing Facility | 16411 Robinson Rd, Gulfport, MS 39503-4879 | 2005-05-31 |
| 1538582143 | Gulfport Healthcare LLC | Skilled Nursing Facility | 11240 Canal Rd, Gulfport, MS 39503-8625 | 2014-02-03 |
| 1720248909 | Ms Hud Boyington, LLC | Skilled Nursing Facility | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2008-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1053834747 | St. Catherine's Village, Inc | Skilled Nursing Facility | 200 Dominican Dr, Madison, MS 39110-8630 | 2017-07-25 |
| 1851839435 | Parker Medical Services, LLC | Skilled Nursing Facility | 1060 Lisa Ln, Terry, MS 39170-8092 | 2017-02-03 |
| 1114386687 | Genesis Healthcare | Skilled Nursing Facility | 2142 E Whitworth St, Hazlehurst, MS 39083-9277 | 2016-02-12 |
| 1003274150 | Vincent Huffstutler | Skilled Nursing Facility | 201 Mary Ellen Dr, Ripley, MS 38663-1658 | 2016-02-04 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1679819890 | Global Home Care, LLC | Skilled Nursing Facility | 4213 Pruitt Rd, West Point, MS 39773-4517 | 2012-12-14 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1700132065 | The Arbor | Skilled Nursing Facility | 600 S Pear Orchard Rd, Ridgeland, MS 39157-4221 | 2012-07-24 |
| 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.