MEMORIAL HOSPITAL AT GULFPORT (NPI# 1962780379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962780379 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL AT GULFPORT |
| Other Organization Name | MEMORIAL EMERGENCY PHYSICIANS |
| Practice Address |
4500 13th St Emergency Department Gulfport MS 39501-2515 |
| Mailing Address |
Po Box 555 Biloxi MS 39533-0555 |
| Practice Telephone | 2288653451 |
| Practice Fax Number | 2288674124 |
| Mailing Telephone | 2288651453 |
| Mailing Fax Number | 2288651457 |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2011-08-16 |
| Authorized Official Name | JEFF T STEINER (VP OF FINANCE) |
| Authorized Official Telephone | 2288653469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Memorial Emergency Physicians | 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 |
4500 13TH ST EMERGENCY DEPARTMENT |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083858674 | Charlton Paige Dennison | Emergency Medicine | 11446 Ashton Ln E, Gulfport, MS 39503-4428 | 2009-04-27 |
| 1487601050 | Kelly Michelle Nations | Emergency Medicine | 1510 Thornton Ave, Gulfport, MS 39501-2157 | 2006-05-28 |
| 1790731222 | Frederick B Gaupp | Emergency Medicine | 10556 Highway 49, Gulfport, MS 39503-4109 | 2006-05-26 |
| 1497735039 | Ronnie Ali | Emergency Medicine | 11564 Stanton Cir, Gulfport, MS 39503-6156 | 2006-01-19 |
| 1972587418 | Stanford Allen Owen | Emergency Medicine | 3300 15th St, Gulfport, MS 39501-3901 | 2005-11-29 |
| 1427580570 | Meagan Spear | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2569 | 2017-03-29 |
| 1689037178 | James Lawrence Rose II | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2016-04-01 |
| 1881070183 | Keystone Medical Services of Gulfport, Inc. | Emergency Medicine | 15200 Community Rd, Gulfport, MS 39503-3085 | 2015-08-10 |
| 1932516945 | Mallory Blakeslee | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2569 | 2014-07-22 |
| 1558681726 | Nghia Duc Nguyen | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2010-06-10 |
| 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.