PRIMESOURCE NURSING SERVICES, INC (NPI# 1952884652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952884652 |
| Entity Type | Organization |
| Organization Name | PRIMESOURCE NURSING SERVICES, INC |
| Practice Address |
1500 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 | 2018-09-10 |
| Last Update Date | 2018-09-10 |
| Authorized Official Name | RHETT PLAUCHE (PRESIDENT) |
| Authorized Official Telephone | 2288651330 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIMESOURCE NURSING SERVICES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801987870 | Primesource Nursing Services, Inc | Nurse Practitioner | 4906 Kendall Ave, Gulfport, MS 39507-4409 | 2006-09-27 |
| 1114583994 | Primesource Nursing Services, Inc | Nurse Practitioner | 2279 Atkinson Rd, Biloxi, MS 39531-2209 | 2019-05-16 |
| 1962573170 | Primesource Nursing Services, Inc | Social Worker | 38 Pass Rd Ste A, Gulfport, MS 39507-3107 | 2006-11-10 |
| Street Address |
1500 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801905310 | Memorial Hospital At Gulfport | Skilled Nursing Facility | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2006-08-29 |
| 1386106094 | Grady Consulting Services, LLC | Internal Medicine | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2019-04-02 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1386193183 | Joannie Evans | Nurse Practitioner | 368 Courthouse Rd, Suite D, Gulfport, MS 39507-1856 | 2016-09-22 |
| 1306147947 | Richard Brown Ray Jr. | Nurse Practitioner | 3413 Washington Ave, Gulfport, MS 39507-3039 | 2010-11-13 |
| 1639220205 | Maureen Stanton | Nurse Practitioner | 33 39th Street, Gulfport, MS 39507 | 2007-01-12 |
| 1679581052 | Eileen A Powell | Nurse Practitioner | 15120 County Barn Rd, Gulf Coast Mental Health Center Csu Unit, Gulfport, MS 39503-1263 | 2006-08-03 |
| 1437784550 | Chantal Sullivan Aprn-bc Pllc | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-03-09 |
| 1740811280 | Chantal Sullivan | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-02-03 |
| 1336780527 | Mary Elizabeth Paul | Nurse Practitioner | 11150 Highway 49, Gulfport, MS 39503-4110 | 2019-09-30 |
| 1457829202 | Art Behavioral Health, Pllc | Nurse Practitioner | 1403 43rd Ave, Gulfport, MS 39501-2545 | 2018-11-09 |
| 1992270995 | Julie K Martin, Pmhnp-bc, LLC | Nurse Practitioner | 1403 43rd Ave, Gulfport, MS 39501-2545 | 2018-10-05 |
| 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.