NP FAMILY MEDICAL CLINIC (NPI# 1255713889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255713889 |
Entity Type | Organization |
Organization Name | NP FAMILY MEDICAL CLINIC |
Other Organization Name | NP FAMILY MEDICAL CLINIC |
Practice Address |
2300 24th Ave Gulfport MS 39501 |
Mailing Address |
2300 24th Ave Gulfport MS 39501-4605 |
Practice Telephone | 2282066500 |
Practice Fax Number | 8666599359 |
Mailing Telephone | 2282066500 |
Mailing Fax Number | 8666599359 |
Enumeration Date | 2015-06-19 |
Last Update Date | 2018-06-08 |
Authorized Official Name | CARRICKA THOMAS (NURSE PRACTITIONER) |
Authorized Official Telephone | 2283269951 |
Authorized Official Credential | FNP-BC |
Is Organization Subpart | Y |
Parent Organization Name | NP ON CALL |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
NP Family Medical Clinic | Doing Business As Name - Organization |
Street Address |
2300 24TH AVE |
City | GULFPORT |
State | MS |
Zip Code | 39501 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538469689 | Carricka D Thomas | Nurse Practitioner | 2300 24th Ave, Gulfport, MS 39501 | 2010-10-22 |
1225685381 | Charlaysha Hall | Nurse Practitioner | 2300 24th Ave, Gulfport, MS 39501-4605 | 2019-08-23 |
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 | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467842641 | Crossroads Adult Day Care | Nursing Facility/Intermediate Care Facility | 519 S Church St, Brookhaven, MS 39601-3807 | 2015-01-27 |
1699108860 | Holistic Geriatric Care LLC | Nursing Facility/Intermediate Care Facility | 10026 Lizelia Rd, Meridian, MS 39305-9595 | 2013-08-12 |
1538492111 | Iva Ward LLC | Nursing Facility/Intermediate Care Facility | 711 Melrose Montebello Pkwy, Natchez, MS 39120-4924 | 2009-09-14 |
1295961969 | River Oaks Management, LLC | Nursing Facility/Intermediate Care Facility | 501 Highway 80 E, Brandon, MS 39042-3257 | 2009-06-08 |
1063697340 | North Bolivar School District | Nursing Facility/Intermediate Care Facility | 615 School Street, Duncan, MS 38740 | 2008-01-04 |
1659555761 | Tallahatchie General Hospital and Extended Care Facility | Nursing Facility/Intermediate Care Facility | 201 South Market Street, Charleston, MS 38921 | 2007-12-26 |
1568683498 | Whitfield Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 2101 Proper St, Corinth, MS 38834-5247 | 2007-05-01 |
1265656391 | Gilberto Patino | Nursing Facility/Intermediate Care Facility | 419 Elizabeth Drive, Leakesville, MS 39451 | 2007-04-12 |
1013048453 | Bruce Nursing Center, Inc. | Nursing Facility/Intermediate Care Facility | 176 Hwy 9 South, Bruce, MS 38915 | 2007-03-08 |
1326178203 | Smith County Ltc, LLC | Nursing Facility/Intermediate Care Facility | 309 Magnolia Drive, Raleigh, MS 39153 | 2007-03-07 |
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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.