Individual provider Active NPI

Stephen T McDavid, D.O.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Ocean Springs, MS
National Provider Identifier
1013958644
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
17316 Issued in MS
Practice address
3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone
(228) 818-1158
Fax
(228) 762-3147
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17316 MS
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 17316 MS Primary

Addresses

Primary practice location

3109 Bienville Blvd
Ocean Springs, MS 39564-4361

Mailing address

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576

Other identifiers 1

IdentifierTypeStateIssuer
000125627MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080225000342 MS Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9032115969 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients
Singing River Health System CurrentSince Jan 28, 2014 Accepting new patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients

Locations

15012 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5050

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1013958644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "228-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644361",
            "telephone_number": "228-818-1158",
            "fax_number": "228-762-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDAVID",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17316",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "MS",
            "license": "17316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000125627",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.