PREVENTATIVE MEDICINE & PRIMARY CARE LLC (NPI# 1992728158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992728158 |
| Entity Type | Organization |
| Organization Name | PREVENTATIVE MEDICINE & PRIMARY CARE LLC |
| Other Organization Name | GAUTIER MEDICAL CLINIC |
| Practice Address |
3300 Ladnier Rd Gautier MS 39553 |
| Practice Telephone | 2284972652 |
| Practice Fax Number | 2284976253 |
| Mailing Telephone | 2284972652 |
| Mailing Fax Number | 2284976253 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RICK D HOOVER (PHYSICIAN OWNER) |
| Authorized Official Telephone | 2284972652 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Gautier Medical Clinic | Doing Business As Name - Organization |
| Street Address |
3300 LADNIER RD |
| City | GAUTIER |
| State | MS |
| Zip Code | 39553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493577 | Rick D Hoover | Family Medicine | 3300 Ladnier Rd, Gautier, MS 39553-5900 | 2005-11-02 |
| 1922582345 | Billy Dycus Jr. | Nurse Practitioner | 3300 Ladnier Rd, Gautier, MS 39553-5909 | 2018-09-21 |
| 1720402266 | Preventative Medicine and Primary Care | Clinic/Center | 3300 Ladnier Rd, Gautier, MS 39553-5909 | 2014-02-04 |
| 1184067084 | Monnica J Reyes, Dba Gautier Medical Clinic | Nurse Practitioner | 3300 Ladnier Rd, Gautier, MS 39553-5909 | 2013-04-10 |
| 1699067959 | Coastal Preventative Medicine, LLC | Clinic/Center | 3300 Ladnier Rd, Gautier, MS 39553-5909 | 2011-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205465044 | Loggan Malone | Dentist | 2808 Us-90 W, Gautier, MS 39553 | 2020-04-03 |
| 1770979775 | Catherine Durham | Counselor | 3407 Shamrock Dr., Gautier, MS 39553 | 2015-04-07 |
| 1851648836 | Pharmatex, LLC | Pharmacy | 4551-d Gautier Vancleave Road, Gautier, MS 39553 | 2012-08-09 |
| 1891957544 | David W Bonderer Dds Pllc | Dentist | 2808 Hwy 90, Suite 1, Gautier, MS 39553 | 2008-06-25 |
| 1790830313 | William D Parrish | Dentist | 713 Us Hwy 90, Gautier, MS 39553 | 2007-01-24 |
| 1073685830 | Jeffrey Lamone Knight | Dentist | 3105 Shaw Dr., Gautier, MS 39553 | 2006-11-15 |
| 1720178437 | Erica B Wilson | Counselor | 3704 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1881781631 | James D Victory | Chiropractor | 315 Highway 90, Gautier, MS 39553 | 2006-10-05 |
| 1508959180 | Robert Douglas Holbert | Internal Medicine | 2105 Old Spanish Trail, Gautier, MS 39553 | 2006-10-02 |
| 1962508119 | Sentry-gautier, Inc. | Nursing Facility/Intermediate Care Facility | 5090 Gautier Vancleave Road, Gautier, MS 39553 | 2006-09-15 |
| Find all providers in zip 39553 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493577 | Rick D Hoover | Family Medicine | 3300 Ladnier Rd, Gautier, MS 39553-5900 | 2005-11-02 |
| 1427230713 | Gregory Barat Fox | Family Medicine | 3407 Shamrock Ct, Gautier, MS 39553 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| 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.