SOUTH COAST PATHOLOGY SERVICES LTD (NPI# 1407967995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407967995 |
| Entity Type | Organization |
| Organization Name | SOUTH COAST PATHOLOGY SERVICES LTD |
| Practice Address |
4500 13th St Gulfport MS 39501-2515 |
| Mailing Address |
5700 Southwyck Blvd Toledo OH 43614-1509 |
| Practice Telephone | 2285752327 |
| Mailing Telephone | 8006781861 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-02-11 |
| Authorized Official Name | DR. JACK CAUSEY (PRESIDENT) |
| Authorized Official Telephone | 2285752327 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07456747 | 05 |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366993321 | D Balder Md Pllc | Specialist | 15190 Community Rd Ste 210, Gulfport, MS 39503-3483 | 2016-10-14 |
| 1619427374 | Anthony Jamaal Anderson | Specialist | 295 Debuys Rd, Gulfport, MS 39507-2800 | 2016-10-06 |
| 1720368905 | Gulfport Medical Weight Loss | Specialist | 12337 Ashley Dr, Suite F, Gulfport, MS 39503-2753 | 2011-08-19 |
| 1679879936 | Jennifer Boudreaux May | Specialist | 13418 Tara Hills Dr, Gulfport, MS 39503-2332 | 2011-02-04 |
| 1720284946 | The Dermatology Clinic, Pllc | Specialist | 11295 East Taylor Road, Gulfport, MS 39503 | 2007-06-25 |
| 1366560435 | Coastal Ear, Nose and Throat, Head and Neck Surgery Associates, Pllc | Specialist | 407 Security Sq, Gulfport, MS 39507-1922 | 2007-03-27 |
| 1790802247 | Gulfcoast Pulmonary Consultants Pa | Specialist | 15190 Community Rd Ste 220, Gulfport, MS 39503-3483 | 2007-03-22 |
| 1811084171 | Eric H Wolfson | Specialist | 1340 Broad Street, Suite 440, Gulfport, MS 39501 | 2006-10-06 |
| 1255424727 | Peter Joseph Bernheim | Specialist | 4500 West Railroad Street, Gulfport, MS 39503 | 2006-10-02 |
| 1174614325 | Spinal & Neurological Surgery of South Mississippi Pllc | Specialist | 15190 Community Road, Suite 300, Gulfport, MS 39503-3499 | 2006-09-27 |
| 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.