Pass Road Elementary

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

R772068 Issued in MS

Legal business name

PASS ROAD ELEMENTARY

Practice address

37 Pass Road
Gulfport, MS 39507

Phone

(228) 865-4659

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Stacey Waldrop, RN, NCSN

Title

School Nurse

Phone

(228) 865-4659

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthy Kids Clinic at Pass Road Elementary Other name

Tax ID family

Bayou View Elementary3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gulfport School District

  • School Registered Nurse
  • Gulfport, MS
  • NPI 1467660407
  NPD tax ID
• Gulfport School District

  • Local Education Agency (LEA)
  • Gulfport, MS
  • NPI 1538371711
  NPD tax ID

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154543528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PASS ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-865-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 PASS ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-865-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASS ROAD ELEMENTARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALDROP",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "SCHOOL NURSE",
        "authorized_official_telephone_number": "228-865-4659",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, NCSN"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, School",
            "state": "MS",
            "license": "R772068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00836002",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Kids Clinic at Pass Road Elementary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hyun Hwa Park, PT, DPT
• Bethany Corinne Parker, MSNA
• Gregory Parker, CFNP
• Stephanie Parks, CRNA
• Lisa Ann Parsons, LCSW
• Kayla Marie Pate, RPH
• Indrajit J Patel, MD
• Simal Patel, MD
• Path of Passion Homecare LLC
• Patient Care Pharmacy Inc

• School Registered Nurse in Gulfport, MS
• Providers in Gulfport, MS by specialty
• School Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.