Active NPI
Renee Gusta
- Home Health Agency
- Biloxi, MS
National Provider Identifier
1114537651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 2434 Pass Rd # D-13
Biloxi, MS 39531-2121 - Phone
- (228) 641-7561
- NPI assigned
- Aug 7, 2020
- Reactivated
- Jun 21, 2023
- Last updated
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 216241 | MS | |
| Phlebotomy Technician | 246RP1900X | 133994 | MS | |
| Home Health Aide | 374U00000X | |||
| Counselor | 101Y00000X | |||
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
2434 Pass Rd # D-13
Biloxi, MS 39531-2121
Mailing address
930 Jefferson Dr
Gulfport, MS 39507-3816
Phone (228) 641-7561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 861387167 | Other | MOBILE PHEBOTOMY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 216241 | MS | MD | School Counselor |
| 133994 | MS | MD | Phlebotomy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creations of Care Home Care LLC. | School | Current | Accepting new patients |
| Creations of Care Home Care LLC. | Phlebotomy | Current | Accepting new patients |
Locations
2434 Pass Rd
#D13
Biloxi, MS 39531
Phone (228) 641-7561
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": "1596758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1114537651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 JEFFERSON DR",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073816",
"telephone_number": "228-641-7561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2434 PASS RD # D-13",
"city": "BILOXI",
"state": "MS",
"postal_code": "395312121",
"telephone_number": "228-641-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTA",
"first_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-07",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"deactivation_date": "2023-02-01",
"reactivation_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "MS",
"license": "216241",
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "MS",
"license": "133994",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOBILE PHEBOTOMY",
"identifier": "861387167",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.