MR. WALTER EDWARD GIPSON IV (NPI# 1023121555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023121555 |
| Entity Type | Individual |
| Full Name | MR. WALTER EDWARD GIPSON IV |
| Credential | MD |
| Practice Address |
1702 Hwy 11 N Ste A Picayune MS 39466 |
| Mailing Address |
1702 A Hwy 11 North Picayune MS 39466 |
| Practice Telephone | 6017993130 |
| Practice Fax Number | 6017993132 |
| Mailing Telephone | 6017993130 |
| Mailing Fax Number | 6017993132 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2017-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 13890 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | BLUE CROSS | 640880384 | 01 |
| MS | 00112115 | 05 |
| Street Address |
1702 HWY 11 N STE A |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466 |
| 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 | 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 |
|---|---|---|---|---|
| 1508175738 | Dcs Instant Care Clinic Inc. | Family Medicine | 3300 Highway 11 N Ste C, Picayune, MS 39466-2000 | 2010-10-05 |
| 1598951279 | Kim Antoinette Mitchell-silver | Family Medicine | 814 S Haugh Ave, Box 1675, Picayune, MS 39466-5350 | 2007-09-17 |
| 1033223904 | Terrance A Johnson | Family Medicine | 1128 Highland Parkway, Suite 200, Picayune, MS 39466-9197 | 2006-08-18 |
| 1881696862 | Delora A Denney | Family Medicine | 12 Medical Plaza Blvd, Picayune, MS 39466-9197 | 2005-08-10 |
| 1528532173 | Kimberly J Carver | Family Medicine | 146 Highland Pkwy Ste C, Picayune, MS 39466-5576 | 2019-01-16 |
| 1992008429 | Delora A. Denney, M.d. | Family Medicine | 12 Medical Plaza Blvd, Suite B, Picayune, MS 39466-9197 | 2010-12-05 |
| 1609008424 | Riser Medical Associates Pllc | Family Medicine | 2274 Highway 43 S, Picayune, MS 39466-8141 | 2009-08-12 |
| 1215164769 | Oladipo Ajose Kusemiju | Family Medicine | 146 Highland Pkwy, Suite C, Picayune, MS 39466-5575 | 2009-06-11 |
| 1942449368 | Highland Community Clinic Network | Family Medicine | 1702 Highway 11 N, Picayune, MS 39466-2016 | 2009-02-09 |
| 1013041011 | James M Riser Md Pa | Family Medicine | 2274 Highway 43 S, Picayune, MS 39466-8141 | 2007-03-14 |
| Find all providers in PICAYUNE | ||||
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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.