Hancock Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HANCOCK FAMILY MEDICINE

Practice address

5400 Indian Hill Blvd
Diamondhead, MS 39525-3334

Phone

(228) 586-9229

Fax

(228) 586-9230

NPI assigned

Aug 28, 2006

Last updated

Nov 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Kellum, MDNPI 1679543102

Title

MD Owner

Phone

(228) 586-9229

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronald Fulton Kellum, M.D.

  • Family Medicine Physician
  • Diamondhead, MS
  • NPI 1679543102
  Authorized official Same address or phone

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1184732448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 INDIAN HILL BLVD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253334",
            "telephone_number": "228-586-9229",
            "fax_number": "228-586-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 INDIAN HILL BLVD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253334",
            "telephone_number": "228-586-9229",
            "fax_number": "228-586-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "KELLUM",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "228-586-9229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "C93454",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Gregory
• Joseph E Gregory, O.D.
• Gulf Coast Life, PLLC
• Gulf Coast Wound Associates LLC
• Michael D Haggerty Jr., IDC
• Hancock Medical Center (DiamondMed Urgent Care)
• Hancock Medical Center (Hancock Orthopedic Clinic)
• Hancock Medical Health Services
• Hancock Medical Health Services, Inc. (Hancock Medical Orthopedic)
• Hancock Medical Health Services, Inc. (Hancock Family Medicine)

• Family Medicine Physician in Diamondhead, MS
• Providers in Diamondhead, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.