JEANNINE A RACEY (NPI# 1891711784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891711784 |
| Entity Type | Individual |
| Full Name | JEANNINE A RACEY |
| Credential | CGNP |
| Practice Address |
1530 Broad Ave Gulfport MS 39501-3601 |
| Mailing Address |
Po Box 6705 Gulfport MS 39506-6705 |
| Practice Telephone | 2288651330 |
| Practice Fax Number | 2288651331 |
| Mailing Telephone | 2288651330 |
| Mailing Fax Number | 2288651331 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2011-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R725927 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P00342756 | 01 | |
| MS | 02858597 | 05 |
| Street Address |
1530 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333629 | Pensacola Health Trust Inc | Skilled Nursing Facility | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2005-08-22 |
| 1699232603 | Caitlin Johnson | Physical Therapist | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2019-02-26 |
| 1225595234 | Allison Martinez | Occupational Therapist | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2019-02-26 |
| 1386117216 | Amber Mathis Cooley | Occupational Therapist | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2019-01-03 |
| 1194298190 | Anne Weaver Gomila | Occupational Therapist | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2019-01-02 |
| 1235548363 | Jessica Fuqua | Nurse Practitioner | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2014-08-02 |
| 1720248909 | Ms Hud Boyington, LLC | Skilled Nursing Facility | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2008-06-11 |
| 1265503791 | Linda Diane Hutchings | Nurse Practitioner | 1530 Broad Ave, Gulfport, MS 39501-3601 | 2006-11-13 |
| 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 | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942711288 | Tiffany Sanders | Nurse Practitioner | 1340 Broad Ave Ste 420, Gulfport, MS 39501-2459 | 2017-10-13 |
| 1558872929 | Laura Rogers | Nurse Practitioner | 1340 Broad Ave Ste 300, Gulfport, MS 39501-2404 | 2017-10-12 |
| 1194925537 | Diane B Vaughn | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1316500887 | Hollie Waldron | Nurse Practitioner | 408 Council Cir Ste C, Tupelo, MS 38801-4949 | 2019-04-19 |
| 1063975621 | Sheila Ann Frederick | Nurse Practitioner | 65 Patton Cemetary Rd, Fulton, MS 38843-9353 | 2019-04-10 |
| 1992263685 | Nadine Theresa James | Nurse Practitioner | 1214 Velma St, Hattiesburg, MS 39402-2751 | 2019-03-12 |
| 1396202396 | Roxane Theresa Moncure | Nurse Practitioner | 919 Rutherford Dr, Jackson, MS 39206-2033 | 2019-02-26 |
| 1750889416 | Katherine Bolden | Nurse Practitioner | 1666 Highway 19 S, Meridian, MS 39301-8209 | 2018-01-29 |
| 1306350129 | Tamika M Broome | Nurse Practitioner | 350 W Woodrow Wilson Ave # 411, Jackson, MS 39213-7681 | 2017-12-01 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1134589930 | Rebecca L. Cauthen | Nurse Practitioner | 885 Liberty Rd Ste 300, Flowood, MS 39232-9006 | 2016-03-07 |
| 1114399284 | Kristie G Jenkins | Nurse Practitioner | 2908 S Lamar Blvd, Suite 100, Oxford, MS 38655-5354 | 2015-10-28 |
| 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.