Individual provider Active NPI

Charles Samms, M.D.

  • Pediatrics Physician
  • Gulfport, MS
National Provider Identifier
1053426908
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
11775 Issued in MS
Practice address
1285 Spring St
Ste a
Gulfport, MS 39507-3423
Phone
(228) 896-6441
Fax
(228) 896-6576
NPI assigned
Aug 20, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11775 MS Primary

Addresses

Primary practice location

1285 Spring St
Ste a
Gulfport, MS 39507-3423

Mailing address

2500 North State Street
JMM Suite 2525
Jackson, MS 39216-4500
Phone (601) 815-9528

Other identifiers 1

IdentifierTypeStateIssuer
00119301MedicaidMS

Other names 1

  • Dr. Charles Samms Professional name

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
I20040408001269 MS Practitioner - Pediatric Medicine 1153315601 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 26, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 26, 2018 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

12259 Highway 49
Gulfport, MS 39503
Phone (228) 396-3179

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Ste 2525
Jackson, MS 39216
Phone (601) 984-6441

Interoperability endpoints

  • Direct secure messaging: csamms85216@ummc.direct-ci.com

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, 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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1053426908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "JMM SUITE 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-9528",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 SPRING ST",
            "address_2": "STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073423",
            "telephone_number": "228-896-6441",
            "fax_number": "228-896-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMS",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "11775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119301",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "SAMMS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.