GULF COAST INTERVENTIONAL PAIN MANAGEMENT CLINIC, INC.


Address: 15164 Dedeaux Rd Ste B, Gulfport, MS 39503-3124
Phone: 2282841642

GULF COAST INTERVENTIONAL PAIN MANAGEMENT CLINIC, INC. (NPI# 1700137205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700137205
Entity Type Organization
Organization Name GULF COAST INTERVENTIONAL PAIN MANAGEMENT CLINIC, INC.
Practice Address 15164 Dedeaux Rd Ste B
Gulfport
MS 39503-3124
Practice Telephone 2282841642
Practice Fax Number 2282841643
Mailing Telephone 2282841642
Mailing Fax Number 2282841643
Enumeration Date 2012-09-24
Last Update Date 2018-05-11
Authorized Official Name SHAWN X. MEI (PHYSICIAN)
Authorized Official Telephone 2282841642
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207LP2900X Anesthesiology
Specialization: Pain Medicine
18456 MS Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS NPI 1407912223 01

Office Location

Street Address 15164 DEDEAUX RD STE B
City GULFPORT
State MS
Zip Code 39503-3124

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1750879003 Heather Lynn Theisen Nurse Practitioner 15190 Community Rd Ste 330, Gulfport, MS 39503 2018-04-23
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Taxonomy Information

Taxonomy Code 207LP2900X
Grouping Allopathic & Osteopathic Physicians
Classification Anesthesiology
Specialization Pain Medicine

Taxonomy Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134214331 Coastal Chronic Pain Services, Pllc Anesthesiology 15190 Community Rd Ste 230b, Gulfport, MS 39503-3483 2006-10-04
1578898664 Gulfport Anesthesia and Pain Treatment, Pllc Anesthesiology 4500 13th St, Gulfport, MS 39501-2515 2009-10-08
1932215464 Brian R Dix Anesthesiology 15190 Community Rd, Suite 230a, Gulfport, MS 39503-3485 2006-08-21
1821104365 Kent T Overmyer Anesthesiology 15190 Community Rd, Suite 230a, Gulfport, MS 39503-3485 2006-08-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588158125 Gulf Coast Anesthesia Associates Anesthesiology 147 Reynoir St Ste 305, Biloxi, MS 39530 2018-06-18
1063878676 Wayne General Hospital Anesthesiology 940 Matthew Dr Ste 8, Waynesboro, MS 39367-2534 2016-01-12
1982996567 Mb Costello Enterprises LLC Anesthesiology 1501 Lakeland Dr Ste 251, Jackson, MS 39216-4848 2011-05-13
1699081745 Anesthesia & Pain Control Services, Inc. Anesthesiology 180b Debuys Rd Ste 211, Biloxi, MS 39531-4407 2010-08-27
1295845311 Bretley Todd Sitzman Anesthesiology 7125 U S Highway 98, Hattiesburg, MS 39402 2006-08-30
1285663633 Joe Christopher Cook I Anesthesiology 114 Byram Business Center Dr, Byram, MS 39272-9636 2006-06-30
1821034596 Rex B Williams Anesthesiology 120 Stone Creek Blvd, Suite 500, Flowood, MS 39232-8205 2006-06-21
1598703852 Miguel Figueroa Anesthesiology 46 Sgt Prentiss Dr Ste 201, Natchez, MS 39120-4751 2006-06-02
1619920584 Pain Consultants of South Mississippi Pa Anesthesiology 106 Asbury Cir, Hattiesburg, MS 39402-1302 2006-05-19
1447210554 Greenwood Leflore Hospital Anesthesiology 1403 Strong Ave, Greenwood, MS 38930 2006-03-23
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Competitor

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City GULFPORT
Zip Code 39503

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Dataset Information

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.

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