NPIMap

Individual provider Active NPI

Nathan Stephen Gill, D.O.

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1194920389
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T-1889 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5582
NPI assigned
Jun 18, 2007
Last updated
Mar 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T-1889 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

811 Wedgewood CT
Brandon, MS 39047-6366
Phone (601) 992-2773

Other identifiers 2

IdentifierTypeStateIssuer
02704891MedicaidMS
1356123MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000150 MS Practitioner - Emergency Medicine 9234207127 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians
Coastal Wound Specialists LLCGroup PAC ID 0244710093, 2 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Suite 140
Gulfport, MS 39501-2445
Phone (228) 575-2950

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4499

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue356
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
T-1889MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Coastal Wound Specialists LLC CurrentSince Jan 12, 2026 Accepting new patients
Gulf Coast Wound Associates LLC CurrentSince Oct 27, 2021 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jan 1, 2015 Accepting new patients
Grandiflora Emergency Physicians Emergency Medicine Past Accepting new patients
Gulf South Wound Care LLC Past Accepting new patients

Locations

303 Reese St
Bay St Louis, MS 39520
Phone (228) 342-0023

5427 Gex Rd
Diamondhead, MS 39525
Phone (228) 236-4262

12261 Highway 49
Ste 11
Gulfport, MS 39503
Phone (228) 575-2176

1340 Broad Ave
Ste 140
Gulfport, MS 39501
Phone (228) 575-2950

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

1436 Central Ave E
Wiggins, MS 39577
Phone (601) 928-1889

Interoperability endpoints

  • Direct secure messaging: ngill@direct.mhg.com

Organizations & group practices 7

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.

Hospital & facility affiliations 63

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1194920389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 WEDGEWOOD CT",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476366",
            "telephone_number": "601-992-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "NATHAN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "T-1889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02704891",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356123",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.