STEPHANIE EONTA (NPI# 1306207519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306207519 |
| Entity Type | Individual |
| Full Name | STEPHANIE EONTA |
| Credential | DO |
| Practice Address |
5501 Marvin Shields Blvd Gulfport MS 39501-9007 |
| Mailing Address |
200 Mullins Dr Lebanon OR 97355-3983 |
| Practice Telephone | 2288225786 |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2019-10-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0102205860 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Mullins Dr, Lebanon, OR 973553983 | 5412590200 |
| Street Address |
5501 MARVIN SHIELDS BLVD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-9007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538143334 | James Elbert Davis | Audiologist | 5501 Marvin Shields Blvd, Nbhc Gulfport, Gulfport, MS 39501-9007 | 2005-12-05 |
| 1497207591 | Jared Castro | Physician Assistant | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2016-10-25 |
| 1366840423 | Julie Bishop | Social Worker | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2014-12-05 |
| 1669722799 | Jamie Lynne Dubeck | Physician Assistant | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2012-09-17 |
| 1306103551 | David Alexander Glenn Jr. | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2012-04-12 |
| 1477819332 | Nathan Daniel Dejager | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2012-04-05 |
| 1174839880 | Jesse Lee Palacios II | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2010-08-19 |
| 1629382957 | Fred Eugene Kasper | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2010-07-28 |
| 1851625446 | Heather Ann Watts | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2009-09-29 |
| 1306075783 | David Charles Halberg | Military Health Care Provider | 5501 Marvin Shields Blvd, Gulfport, MS 39501-9007 | 2009-07-07 |
| Find all providers in the same location | ||||
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184080855 | Racquel Simone Allen | General Practice | 5301 Bainbridge Ave # 58, Gulfport, MS 39501-9041 | 2016-01-11 |
| 1427128255 | Eugene David Mcnally | General Practice | 350 Cowan Road, Gulfport, MS 39507 | 2006-11-09 |
| 1013011303 | Stephen W Baker | General Practice | 14055 Seaway Rd., Gulfport, MS 39503 | 2006-09-08 |
| 1447248661 | Curtis A Broussard | General Practice | 12330 Ashley Dr, Gulfport, MS 39503-2737 | 2005-10-11 |
| 1053818245 | Landmark Medical of Mississippi PC | General Practice | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2018-04-12 |
| 1245666742 | Ochsner Clinic LLC | General Practice | 14055 Seaway Rd, Gulfport, MS 39503-4610 | 2013-09-17 |
| 1467888966 | Ochsner Clinic LLC | General Practice | 4215 15th St, Gulfport, MS 39501-2523 | 2013-09-17 |
| 1609158260 | Delphine K. Shannon | General Practice | 12261 Highway 49, Suite 6, Gulfport, MS 39503-2975 | 2011-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487260329 | Good Shepard LLC | General Practice | 632 Lakeland East Dr, Flowood, MS 39232-9565 | 2020-09-16 |
| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1780241729 | Southeast Reginald Solutions,pllc | General Practice | 310 River Forest Ln, Brandon, MS 39047-7020 | 2019-05-24 |
| 1235601907 | William Carey University | General Practice | 710 William Carey Pkwy, Hattiesburg, MS 39401-7842 | 2018-12-19 |
| 1770050908 | Thompson Medical Service, LLC | General Practice | 1200 Hwy 15 North, Blue Mountain, MS 38610 | 2018-10-25 |
| 1790265932 | Antonio Reyes Del Castillo Jr. | General Practice | 590 Parchman Road 12, Parchman, MS 38738-3001 | 2018-08-16 |
| 1700397239 | Marysol Camejo Romero | General Practice | 728 Benwick Dr, Brandon, MS 39047-8111 | 2017-10-24 |
| 1013431519 | Madena Jane Gibson | General Practice | 1695 Moses Rd, Raymond, MS 39154-8766 | 2017-07-27 |
| 1942740188 | Personalized Wellness | General Practice | 573 Highway 51 Ste D, Ridgeland, MS 39157-2605 | 2017-03-07 |
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| 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.