PEARL RIVER EMERGENCY GROUP LLC (NPI# 1922066190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922066190 |
| Entity Type | Organization |
| Organization Name | PEARL RIVER EMERGENCY GROUP LLC |
| Practice Address |
801 Goodyear Blvd Picayune MS 39466-3221 |
| Mailing Address |
200 Corporate Blvd Suite 201 Lafayette LA 70508-3870 |
| Practice Telephone | 8008939698 |
| Mailing Telephone | 8008939698 |
| Mailing Fax Number | 3372627246 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM SCHUMACHER (CEO) |
| Authorized Official Telephone | 8008939698 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| X | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09057209 | 05 |
| Street Address |
801 GOODYEAR BLVD |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466-3221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578564712 | Picayune Clinic LLC | General Acute Care Hospital | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2005-08-10 |
| 1750665592 | Highland Community Clinic Network | Obstetrics & Gynecology | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2011-09-28 |
| 1164738712 | Deep South Anesthesia, Inc | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2010-08-20 |
| 1730310335 | Highland Community Clinic Network | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2009-07-30 |
| 1861677957 | Forrest County General Hospital | Pharmacy | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2008-01-08 |
| 1306976238 | Forrest County General Hospital | General Acute Care Hospital | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-03-07 |
| 1053447037 | Jed Dean Zak | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-02-26 |
| 1053469700 | Fgh Physician Billing | Family Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2007-01-08 |
| 1477636363 | Milton Nicholas Dudenhefer IIi | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466 | 2006-10-23 |
| 1588747489 | Vincent Guy Lombardo | Nurse Anesthetist, Certified Registered | 801 Goodyear Blvd, Picayune, MS 39466 | 2006-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270684 | Ashley Royerre Talley | Speech-Language Pathologist | 621 W Canal St, Picayune, MS 39466 | 2016-12-21 |
| 1306396213 | Kathy English | Counselor | 102 Roy St, Picayune, MS 39466 | 2016-10-04 |
| 1124379631 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 23350 Highway 43, Picayune, MS 39466 | 2012-09-24 |
| 1578876280 | Joy A. Weidemann | Social Worker | 120 Street A Ste C, Picayune, MS 39466 | 2010-07-22 |
| 1407188477 | Picayune School District | Local Education Agency (LEA) | 706 Goodyear Blvd., Picayune, MS 39466 | 2010-02-02 |
| 1164751079 | Picayune School District Early Head Start | Early Intervention Provider Agency | 1620 Rosa St, Picayune, MS 39466 | 2009-12-24 |
| 1124352505 | Stephanie Deanne Farrell | Speech-Language Pathologist | 201 E. Second Street, Picayune, MS 39466 | 2009-10-01 |
| 1902084007 | Ludwick L Lohnes Dc LLC | Chiropractor | 214 Norwood Street, Picayune, MS 39466 | 2008-01-31 |
| 1932395878 | Prohealth Solutions, Inc | Occupational Therapist | 722 West Canal Street, Picayune, MS 39466 | 2007-09-24 |
| 1669677431 | Terri L Bordelon | Social Worker | 214 N Curran, Suite A, Picayune, MS 39466 | 2007-06-20 |
| Find all providers in zip 39466 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104869353 | Dirk H. Danielson | Emergency Medicine | 801goodyear Blvd., Picayune, MS 39466-3221 | 2006-06-14 |
| 1316980931 | Patrizia M. Colbert | Emergency Medicine | 801 Goodyear Blvd., Picayune, MS 39466-3221 | 2006-06-13 |
| 1497268312 | Highland Emergency Physicians, Pa | Emergency Medicine | 130 Highland Pkwy, Picayune, MS 39466-5574 | 2017-11-14 |
| 1730310335 | Highland Community Clinic Network | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2009-07-30 |
| 1023197142 | Ujwal Meka | Emergency Medicine | 1839 Cooper Rd Ste 100, Picayune, MS 39466-2835 | 2006-11-02 |
| 1649384512 | Acs Emergency Physicians Pa | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2006-08-18 |
| 1942212543 | Clide S Sherrod | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2006-08-12 |
| 1689685844 | John P Louwerens | Emergency Medicine | 801 Goodyear Blvd, Picayune, MS 39466-3221 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780201145 | Sabrina Marie Azavedo | Emergency Medicine | 3283 Shadowood Ln, Corinth, MS 38834-6030 | 2020-07-01 |
| 1275172736 | Relias Emergency Medicine Specialists of West Point, LLC | Emergency Medicine | 150 Medical Center Dr, West Point, MS 39773-0428 | 2020-01-02 |
| 1790130151 | Patrick Bryant | Emergency Medicine | 5001 Hardy Street, Hattiesburg, MS 39402 | 2016-05-04 |
| 1679935381 | Rommel Asagwara | Emergency Medicine | 1060 E County Line Rd Ste 1a, Ridgeland, MS 39157-1937 | 2016-03-22 |
| 1588034227 | Srikar Karanam | Emergency Medicine | 114 Breckenridge Dr Apt 203, Hattiesburg, MS 39402-3709 | 2015-10-06 |
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1942612015 | Emergency Associates Pllc | Emergency Medicine | 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 | 2014-05-23 |
| 1720362270 | David Kennedy Stone | Emergency Medicine | 102 Pine Ct, Brandon, MS 39047-8313 | 2011-10-03 |
| 1083995674 | Obhg Mississippi, P.C. | Emergency Medicine | 1225 N State St Ste B1, Jackson, MS 39202-2072 | 2011-09-09 |
| 1114238425 | Kevin Lee Beason | Emergency Medicine | 10151 Road 1343, Philadelphia, MS 39350-4101 | 2010-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEARL RIVER EMERGENCY GROUP LLC.
| 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.