Individual provider Active NPI

Renee Gusta

  • Home Health Agency
  • Biloxi, MS
National Provider Identifier
1114537651
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
861387167OtherMOBILE 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

LicenseStateTypeSpecialty
216241MSMDSchool Counselor
133994MSMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Creations of Care Home Care LLC. School CurrentSince Nov 8, 2020 Accepting new patients
Creations of Care Home Care LLC. Phlebotomy CurrentSince Jan 2, 2022 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.

Verify at the official NPI Registry.