Victor P Polito, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R529788 Issued in MS

Practice address

15190 Community Rd
Suite 230a
Gulfport, MS 39503-3485

Phone

(228) 831-0204

Fax

(228) 831-1868

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gulfport Outpatient Anesthesia, P.a.

  • Anesthesiology Physician
  • Gulfport, MS
  • NPI 1245402148
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013064872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 230A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-0204",
            "fax_number": "228-831-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 230A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-0204",
            "fax_number": "228-831-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "VICTOR",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R529788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122610",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Pittman, CRNA
• Kayana Pittman
• Lauren Pittman, RD, LD
• Virginia Madison Plauche', NNP-BC
• Eric Vincent Plott, MD
• Anthony Womack Pollard, PH.D.
• Colby Pomeroy, LMFT
• Amy L Pontius, NP-C
• Asia Pope
• Lauren Porter, LMSW

• Certified Registered Nurse Anesthetist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.