NPIMap

Individual provider Active NPI

Deirdre Lee Breland, NP

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1023690989
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904579 Issued in MS
Practice address
1302 44TH Ave
Gulfport, MS 39501-2552
Phone
(228) 687-8235
Fax
(228) 206-6470
NPI assigned
Apr 21, 2021
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904579 MS Primary

Addresses

Primary practice location

1302 44TH Ave
Gulfport, MS 39501-2552

Mailing address

PO Box 1089
Hammond, LA 70404-1089
Phone (995) 892-7070

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dbreland@mhg.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210527000239 MS Practitioner - Nurse Practitioner 2668871419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Care Associates LLCGroup PAC ID 0840314548, 117 clinicians

Practice addresses (Care Compare)

1302 44TH Ave
Gulfport, MS 39501-2552
Phone (985) 892-7070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.56 of 100Reported as group
Quality
43.22
Promoting interoperability
88
Improvement activities
40
Cost
31.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904579MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Wound Associates LLC CurrentSince May 1, 2022 Accepting new patients
Wound Care Associates LLC CurrentSince Apr 17, 2023 Accepting new patients

Locations

16065 Lamonte Dr
Hammond, LA 70403
Phone (985) 956-7771

5427 Gex Rd
Diamondhead, MS 39525
Phone (228) 236-4262

1302 44th Ave
Gulfport, MS 39501
Phone (228) 687-8235

1500 Broad Ave
Gulfport, MS 39501
Phone (228) 236-4262

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

431 W Race St
Rolling Fork, MS 39159
Phone (662) 795-0440

1436 Central Ave E
Wiggins, MS 39577
Phone (601) 928-1889

Organizations & group practices 2

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

Hospital & facility affiliations 63

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1023690989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704041089",
            "telephone_number": "995-892-7070",
            "fax_number": "985-892-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 44TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012552",
            "telephone_number": "228-687-8235",
            "fax_number": "228-206-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRELAND",
        "first_name": "DEIRDRE",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dbreland@mhg.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 13th St",
            "city": "Gulfport",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395012515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.