Individual provider Active NPI

Peter Linh Tran II

  • Pharmacist
  • Gulfport, MS
National Provider Identifier
1043822950
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-14700 Issued in MS
Practice address
15371 Dedeaux Rd
Gulfport, MS 39503-3855
Phone
(228) 539-9890
Fax
(228) 539-0238
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-14700 MS Primary

Addresses

Primary practice location

15371 Dedeaux Rd
Gulfport, MS 39503-3855

Mailing address

15371 Dedeaux Rd
Gulfport, MS 39503-3855
Phone (228) 539-9890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E-14700MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Sep 8, 2025 Accepting new patients
Walgreen Co PastSince Aug 23, 2020 Accepting new patients

Locations

15371 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 539-9890

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.

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1043822950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15371 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033855",
            "telephone_number": "228-539-9890",
            "fax_number": "228-539-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15371 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033855",
            "telephone_number": "228-539-9890",
            "fax_number": "228-539-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PETER",
        "middle_name": "LINH",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-14700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.