MONTOYA DEMONT GUNN (NPI# 1851592067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851592067 |
| Entity Type | Individual |
| Full Name | MONTOYA DEMONT GUNN |
| Credential | IDC |
| Practice Address |
1801 Fuller Rd Suite A-01 Meridian MS 39309-5106 |
| Mailing Address |
3007 12th Ave Meridian MS 39305-4820 |
| Practice Telephone | 6016793973 |
| Mailing Telephone | 9103896914 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2009-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1801 FULLER RD SUITE A-01 |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39309-5106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972583664 | Rowland Eugene Mccoy | Dentist | 1801 Fuller Rd, Bldg 367, Meridian, MS 39309-5106 | 2006-01-19 |
| 1609076033 | Branch Medical Clinic Meridian | Clinic/Center | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2007-07-24 |
| 1720144652 | Earl Gastador Bercide | Military Health Care Provider | 1801 Fuller Rd, Meridian, MS 39309-5107 | 2006-12-28 |
| 1033294533 | Christopher Robert Sharpe | Physician Assistant | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-10-25 |
| 1154414191 | Steven M. Piper | General Practice | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-10-02 |
| 1700983558 | Naval Hospital Pensacola | Pharmacy | 1801 Fuller Rd, Bldg 367 Ste A01, Meridian, MS 39309-5107 | 2006-09-20 |
| 1265463095 | Milli M Floyd | Pharmacist | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-07-06 |
| 1790755684 | Robert James Wishmeyer | Physician Assistant | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-01-24 |
| 1669442786 | James Eugene Clark | Dentist | 1801 Fuller Rd, Suite D-18, Meridian, MS 39309-5106 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528038296 | Johnny Lee Cosby | Optometrist | 1801 Fuller Rd Ste A01, Meridian, MS 39309 | 2006-01-25 |
| 1093863433 | Angeles L Ballou | Nurse Practitioner | Nbhc Nas Meridian, 1801 Fuller Road Bldg 367, Meridian, MS 39309-0001 | 2007-01-08 |
| 1194705665 | Bonnie Roberts Chavez | Psychologist | Naval Branch Health Clinic, 1801 Fuller Rd. Suite A-01 Bldg 367, Meridian, MS 39309-0001 | 2006-01-19 |
| 1861472748 | Karlyna L. D. Andersen | Family Medicine | Naval Branch Health Clinic, 1801 Fuller Rd. Suite A-01 Bldg 367, Meridian, MS 39309-0001 | 2006-01-18 |
| 1477533255 | Craig Morgenstern | Family Medicine | Naval Branch Health Clinic, 1801 Fuller Road, Suite A-01, Bldg 367, Meridian, MS 39309-0001 | 2006-01-18 |
| 1568545556 | Angela Mcdonald | Nurse Practitioner | Nbhc Meridian 1801 Fuller St Bldg 367, Meridian, MS 39309-3107 | 2006-10-23 |
| 1265843155 | Patricia Everette | Social Worker | 1155 Rosenbaum Ave, Building 405, Naval Air Station, Meridian, MS 39309-5062 | 2014-05-13 |
| 1245210269 | Ann Louise Lagreco | Dentist | Naval Branch Health Clinic, 1801 Fuller Rd Ste A-01, Meridian, MS 39309-5106 | 2006-01-17 |
| 1972917060 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 367 Fuller Rd Ste A-15, Meridian, MS 39309-5408 | 2014-06-17 |
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720144652 | Earl Gastador Bercide | Military Health Care Provider | 1801 Fuller Rd, Meridian, MS 39309-5107 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043747553 | Rowdy Pameticky | Military Health Care Provider | 952 Poni Pl, Diamondhead, MS 39525-4135 | 2017-05-15 |
| 1528515046 | Nicolas Riley | Military Health Care Provider | 5501 Marvin Shields Blvd., Gulfport, MS 39501-5007 | 2016-09-01 |
| 1235519984 | Bradley Craig Wilson | Military Health Care Provider | 2807 Montclair Ave, Pascagoula, MS 39567-5287 | 2015-06-08 |
| 1477932200 | Michael Alexander Boartfield | Military Health Care Provider | 4033a Mallard Cv, Gulfport, MS 39501-2833 | 2015-05-26 |
| 1336536531 | Jeffrey Alexander Leemauk | Military Health Care Provider | 4010a Blue Heron Way, Gulfport, MS 39501-2815 | 2015-04-25 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| 1427316041 | Jeremiah John Baldwin | Military Health Care Provider | 5303 Marvin Shields Blvd, Gulfport, MS 39501-9013 | 2012-05-02 |
| 1215232830 | Jessica E Shores | Military Health Care Provider | 1000 Access Rd Bldg 2026, Pascagoula, MS 39567 | 2011-01-12 |
| 1124341763 | Trevor James Trout | Military Health Care Provider | 2603 Lower Gainesville Rd, Stennis Space Center, MS 39529-0001 | 2010-03-10 |
| 1245563162 | Jenesia Arielle Dillow Ordonia | Military Health Care Provider | 3158b Holloway Dr, Gulfport, MS 39501-9030 | 2009-09-10 |
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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.