Organization Active NPI

The Diabetes Center, PLLC

  • Adult Health Nurse Practitioner
  • Ocean Springs, MS
National Provider Identifier
1043391436
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R854239 Issued in MS
Legal business name
THE DIABETES CENTER, PLLC
Practice address
1278 Ocean Springs Rd
Ocean Springs, MS 39564-3409
Phone
(228) 875-3606
Fax
(228) 875-3687
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Authorized official

Name
Ms. Kathleen C Arnold, A.N.P.NPI 1134107139
Title
Owner
Phone
(228) 875-3606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X R854239 MS Primary

Addresses

Primary practice location

1278 Ocean Springs Rd
Ocean Springs, MS 39564-3409

Mailing address

3099 Bienville Blvd
Ocean Springs, MS 39564-4308
Phone (228) 875-3606

Other identifiers 1

IdentifierTypeStateIssuer
01850731MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051117000821 MS Part B Supplier - Clinic/Group Practice 1759300858 Receives reassigned benefits from 10 practitioners
Practice locations: Ocean Springs, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1047353Diabetes Center, PLLC, the1278 Ocean Springs Rd, Ocean Springs, MS 39564Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory

Locations

1278 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-3606

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1043391436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644308",
            "telephone_number": "228-875-3606",
            "fax_number": "228-875-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643409",
            "telephone_number": "228-875-3606",
            "fax_number": "228-875-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DIABETES CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-875-3606",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "A.N.P."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R854239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01850731",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.