MEMORIAL HOSPITAL AT GULFPORT (NPI# 1811185192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811185192 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | RHEUMATOLOGY AT MHG |
| Practice Address |
1340 Broad Ave Suite 440 Gulfport MS 39501-2404 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2288648454 |
| Practice Fax Number | 2288651451 |
| Mailing Telephone | 2288648454 |
| Mailing Fax Number | 2288651451 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2008-12-11 |
| Authorized Official Name | MR. RANDY ROBINSON (ADMINISTRATOR) |
| Authorized Official Telephone | 2288651453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
19730 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00182510 | 05 |
| Other Name | Type Code |
|---|---|
| Rheumatology at MHG | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215354402 | Memorial Hospital At Gulfport | Physical Therapy Assistant | 2781 C.t. Switzer, Suite 404, Biloxi, MS 39531 | 2014-03-25 |
| 1609203173 | Memorial Hospital At Gulfport | Internal Medicine | 1756 Popps Ferry Rd Ste A, Biloxi, MS 39532-2118 | 2013-09-30 |
| 1285070672 | Memorial Hospital At Gulfport | Occupational Therapist | 2781 C. T. Switzer Dr., Suite 404, Biloxi, MS 39531-4535 | 2013-05-13 |
| 1205129137 | Memorial Hospital At Gulfport | Family Medicine | 20006 Hwy 53, 7 Sunshine Place, Gulfport, MS 39503-0000 | 2011-05-25 |
| 1275848889 | Memorial Hospital At Gulfport | Internal Medicine | 4405 E Aloha Dr, Suite 1, Diamondhead, MS 39525-3380 | 2010-08-09 |
| 1649585258 | Memorial Hospital At Gulfport | Internal Medicine | 784 Vieux Marche Mall, Biloxi, MS 39530-3822 | 2010-08-09 |
| 1730411463 | Memorial Hospital At Gulfport | Pediatrics | 12259 Highway 49, Suite C, Gulfport, MS 39503-3063 | 2010-02-05 |
| 1649404435 | Memorial Hospital At Gulfport | Internal Medicine | 970 Tommy Munro Dr, Biloxi, MS 39532-2130 | 2009-05-07 |
| 1295978435 | Memorial Hospital At Gulfport | Psychiatry & Neurology | 5407 Indian Hill Blvd, Diamondhead, MS 39525-3324 | 2009-04-17 |
| 1255524211 | Memorial Hospital At Gulfport | Clinic/Center | 1340 Broad Ave Ste 220, Gulfport, MS 39501-2404 | 2007-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| Street Address |
1340 BROAD AVE SUITE 440 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912904590 | Jesse Pullen Penico | Internal Medicine | 1340 Broad Ave, Suite 300, Gulfport, MS 39501-2404 | 2005-06-28 |
| 1306409040 | Lissa Kelly Baber | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2019-04-18 |
| 1780191577 | Tbd Acquisition II LLC | Social Worker | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2018-01-03 |
| 1629517115 | Delana Mooney | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2017-02-16 |
| 1396299590 | Charles Strange | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2016-08-05 |
| 1942699988 | Beth Ann Gruzinskas | Nurse Practitioner | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1720477714 | Lacey Grimes Lichtenstein | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1669872974 | Jamie B Varnado | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2014-08-25 |
| 1700121209 | Danielle Ronquille Lipski | Occupational Therapist | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2012-12-10 |
| 1164767778 | Shannon Ann Church | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2012-12-07 |
| 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 | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366774093 | Memorial Hospital At Gulfport | Internal Medicine | 4540 W Railroad St, Suite B, Gulfport, MS 39501-2480 | 2010-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835305 | North Mississippi Medical Center, Inc. | Internal Medicine | 408 Council Cir Ste A, Tupelo, MS 38801-4949 | 2019-08-09 |
| 1619356722 | Lauren Parker Hayward | Internal Medicine | 504 Azalea Dr Ste 4, Oxford, MS 38655-5397 | 2015-05-21 |
| 1649686395 | Madison Medical Rheumatology, LLC | Internal Medicine | 1607 Doctor's Drive, Madison, MS 39110-8671 | 2014-07-02 |
| 1952745663 | Neal Shparago Do Pa | Internal Medicine | 1190 N State St Ste 302, Jackson, MS 39202-2413 | 2013-04-24 |
| 1851585004 | Dedri Markita Ivory | Internal Medicine | 3510 Pemberton Square Blvd, Vicksburg, MS 39180-5506 | 2007-08-30 |
| 1124247341 | Matthew Bernard Carroll | Internal Medicine | 3101 Denny Ave Ste 240, Pascagoula, MS 39581-5307 | 2007-04-25 |
| 1851431159 | David Ian Weiss | Internal Medicine | 15 Orleans Dr, Hattiesburg, MS 39402 | 2007-02-07 |
| 1487747234 | Rheumatology Associates, Pllc | Internal Medicine | 1190 N State St Ste 303, Jackson, MS 39202-2413 | 2006-10-02 |
| 1760495071 | Jean Guyton Gispen | Internal Medicine | Employee Health Service, V. B. Harrison Building, Rebel Drive, University, MS 38677 | 2006-08-15 |
| 1720092547 | Chris H Benson | Internal Medicine | 104 Millsaps Dr, Hattiesburg, MS 39402-1328 | 2006-07-28 |
| 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.