Gulf Coast Internal Medicine PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GULF COAST INTERNAL MEDICINE PLLC

Practice address

1721 Medical Park Dr
Ste 101
Biloxi, MS 39532

Phone

(228) 388-0062

Fax

(228) 388-1701

NPI assigned

Jun 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Valerie Reed Lenox, MD

Title

Physician

Phone

(228) 388-0062

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip D Compton II, M.D.

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1578591186
  NPD (past)
• Leigh P Drace, CFNP

  • Nurse Practitioner
  • Gulfport, MS
  • NPI 1013064245

  Internal Medicine

  NPD (past)
• Reta Virginia Lumpkin, CFNP

  • Family Nurse Practitioner
  • Picayune, MS
  • NPI 1285705822
  NPD (past)
• Rachael F Tadlock, M.D.

  • Internal Medicine Physician
  • Biloxi, MS
  • NPI 1942367164
  NPD (past)
• Marilyn O Mora, M.D.

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1669539870
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164450359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 MEDICAL PARK DR",
            "address_2": "STE 101",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39532",
            "telephone_number": "228-388-0062",
            "fax_number": "228-388-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 MEDICAL PARK DR",
            "address_2": "STE 101",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39532",
            "telephone_number": "228-388-0062",
            "fax_number": "228-388-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LENOX",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "228-388-0062",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE LEIGH DRACE",
            "identifier": "R784087",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE RACHEL TADLOCK",
            "identifier": "17319",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015465",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE VALERIE LENOX",
            "identifier": "13331",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE MARILYN MORA",
            "identifier": "16183",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Asthma and Allergy Clinic
• Gulf Coast Audiology, Inc.
• Gulf Coast Consultants, Infectious Diseases, LLC
• Gulf Coast Dental Care of Biloxi PLLC
• Gulf Coast Gynecology Clinic, PLLC
• Gulf Coast Mobile Massage Spa
• Gulf Coast Neurology Clinic, P.a.
• Gulf Coast Neuropsychology and Neuro-Rehabilitation
• Gulf Coast Oral & Facial Surgery, P.a.
• Gulf Coast Outpatient Surgery Center, LLC

• Internal Medicine Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Internal Medicine Physician 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.