DR. BART J. EDMISTON SR. (NPI# 1508934464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508934464 |
| Entity Type | Individual |
| Full Name | DR. BART J. EDMISTON SR. |
| Credential | MD |
| Practice Address |
3631 Bienville Blvd. Suite A Ocean Springs MS 39564 |
| Mailing Address |
4500 13th St Gulfport MS 39501-2515 |
| Practice Telephone | 2288189620 |
| Practice Fax Number | 2288189750 |
| Mailing Telephone | 2285752902 |
| Mailing Fax Number | 2285752917 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 20298 | MS | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | EC-05-091 | ME | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
20298 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
3631 BIENVILLE BLVD. SUITE A |
| City | OCEAN SPRINGS |
| State | MS |
| Zip Code | 39564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194810408 | Christopher P. Karcher | Psychiatry & Neurology | 3631 Bienville Blvd., Ste A, Ocean Springs, MS 39564 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996401 | Shelby Bourgeois | Speech-Language Pathologist | 108 Heron Park Pl, Ocean Springs, MS 39564 | 2020-09-10 |
| 1467010520 | Rachel Stephenie Knox | Student in an Organized Health Care Education/Training Program | 81mdss/gme 301 Fisher St., Rm 1g123, Keesler Afb, MS 39564 | 2019-06-04 |
| 1457839292 | Polly Anne Lampon | Registered Nurse | 2301 Rue Beaux Chenes, Ocean Springs, MS 39564 | 2018-08-03 |
| 1578062725 | Gulf Coast Sleep Medicine LLC | Clinic/Center | 2112 Bienville Blvd., Suite P, Ocean Springs, MS 39564 | 2018-02-02 |
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1386016749 | L. Randy Buntyn, D.m.d., Pllc | Dentist | 1203 Government St., Ocean Springs, MS 39564 | 2015-10-26 |
| 1467835629 | Msmobileyes Inc. | Optometrist | 2510 Bileville Blvd, Ocean Springs, MS 39564 | 2015-07-07 |
| 1659760999 | Clark Jamison Levi | Pharmacist | 1019 Government Street Suite F & D, Ocean Springs, MS 39564 | 2015-01-09 |
| 1932545480 | Therese Anne Hanna | Nurse Practitioner | 6900 Washington Avenue, Ocean Springs, MS 39564 | 2013-05-10 |
| 1346589421 | Jennah Claine Ladner | Nurse Practitioner | 1137 Ocean Springs Road, Ocean Springs, MS 39564 | 2013-02-08 |
| Find all providers in zip 39564 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497752760 | Fani B Manney | Pain Medicine | #4 Doctors Dr, Suite C, Ocean Springs, MS 39564 | 2005-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1922218627 | Robert Fortier Bensen | Pain Medicine | 445 Security Sq, Gulfport, MS 39507-1922 | 2007-05-23 |
| 1811098874 | Laurel Pain Clinic Pa | Pain Medicine | 1706 W 12th St, Laurel, MS 39440-2559 | 2006-09-25 |
| 1922092881 | Eric Pearson | Pain Medicine | 1001 14th St, Meridian, MS 39301-4458 | 2005-09-07 |
| 1417953050 | Steven Thomas Richey | Pain Medicine | 122 Airways Pl, Southaven, MS 38671-5872 | 2005-06-27 |
| 1316558893 | Mississippi Pain Management, Pllc | Pain Medicine | 1080 River Oaks Dr Ste B103, Flowood, MS 39232-7602 | 2020-08-10 |
| 1083193031 | Bacas Interventional Pain Management, LLC | Pain Medicine | 1430 Highway 4 E, Holly Springs, MS 38635-2140 | 2018-08-10 |
| 1356848014 | Flowood Pain Center, LLC | Pain Medicine | 120 Stone Creek Blvd Ste 500, Flowood, MS 39232-8210 | 2018-04-10 |
| 1134596760 | Pain Partners, LLC | Pain Medicine | 1001 14th St, Meridian, MS 39301-4458 | 2015-08-31 |
| 1124452859 | St Dominic Medical Associates LLC | Pain Medicine | 970 Lakeland Dr, Suite 45, Jackson, MS 39216-4635 | 2013-08-29 |
| Find all providers with the same taxonomy | ||||
| City | OCEAN SPRINGS |
| Zip Code | 39564 |
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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.