HEART HYPERTENSION CHOLESTEROL & DIABETES CARE LLC (NPI# 1902233778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902233778 |
| Entity Type | Organization |
| Organization Name | HEART HYPERTENSION CHOLESTEROL & DIABETES CARE LLC |
| Other Organization Name | PRIMARY CARE PLUS |
| Practice Address |
15444 Dedeaux Rd Ste B Gulfport MS 39503-2637 |
| Practice Telephone | 2288329038 |
| Practice Fax Number | 2288329990 |
| Mailing Telephone | 2288329038 |
| Mailing Fax Number | 2288329990 |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2019-10-05 |
| Authorized Official Name | STEVEN SMITH (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 5022449859 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01050841 | 05 | |
| MS | MEDICARE PTAN | 329259 | 01 |
| Other Name | Type Code |
|---|---|
| PRIMARY CARE PLUS | Doing Business As Name - Organization |
| Street Address |
15444 DEDEAUX RD STE B |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-2637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508949538 | Joseph Daniel Hull | Family Medicine | 15444 Dedeaux Rd Ste B, Gulfport, MS 39503-2637 | 2006-10-23 |
| 1790224871 | Alvin Walsh IIi | Nurse Practitioner | 15444 Dedeaux Rd Ste B, Gulfport, MS 39503-2637 | 2017-02-22 |
| 1053554808 | Juliet W Richards | Nurse Practitioner | 15444 Dedeaux Rd Ste B, Gulfport, MS 39503-2637 | 2009-04-09 |
| 1386772283 | Cherryl D Purvis | Internal Medicine | 15444 Dedeaux Rd Ste B, Gulfport, MS 39503-2637 | 2007-03-01 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891100129 | William Hill | Internal Medicine | 7 Holly Ct, Gulfport, MS 39503-6211 | 2014-06-25 |
| 1609296037 | Hugo C. Nievas, Md, Pa | Internal Medicine | 1017 44th Ave, Gulfport, MS 39501-2547 | 2014-04-24 |
| 1821415357 | Michael Payment Md Cardiology Pa | Internal Medicine | 4533 13th St, Gulfport, MS 39501-2516 | 2014-03-21 |
| 1528178415 | Cyril Vk Bethala | Internal Medicine | 4507 15th St, Gulfport, MS 39501 | 2006-08-30 |
| 1649380536 | Jay J Libys | Internal Medicine | 14055 Seaway Road, Gulfport, MS 39503 | 2006-08-30 |
| 1487683231 | Bassam Baroudi | Internal Medicine | 4215 15th St, Gulfport, MS 39501-2523 | 2006-07-02 |
| 1710916564 | Wakkas Tayara | Internal Medicine | 1391 Broad Ave, Gulfport, MS 39501-2419 | 2006-07-02 |
| 1720039043 | Mohammed I Awaad | Internal Medicine | 1104 Broad Ave, Gulfport, MS 39501-2414 | 2006-05-12 |
| 1295353878 | Ochsner Mississippi, LLC | Internal Medicine | 4507 15th St, Gulfport, MS 39501-2500 | 2020-07-09 |
| 1952741977 | Umair Zafar Malik | Internal Medicine | 4215 15th St, Gulfport, MS 39501-2523 | 2013-07-05 |
| Find all providers in GULFPORT | ||||
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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.