Pascagoula Urgent Care Center LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

13038 Issued in MS

Legal business name

PASCAGOULA URGENT CARE CENTER LLC

Practice address

4305 Denny Ave
Pascagoula, MS 39581-5509

Phone

(228) 762-2044

NPI assigned

Sep 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Scott Cooper, M.D.

Title

Owner

Phone

(228) 762-2044

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1252713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252713600000",
    "number": "1073846770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815509",
            "telephone_number": "228-762-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815509",
            "telephone_number": "228-762-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASCAGOULA URGENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-12",
        "last_updated": "2009-09-12",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-762-2044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MS",
            "license": "13038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1023267630",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Urgent Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2009; 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.