NPIMap

Organization Active NPI

Garden Park Hospitalist Program LLC

  • Hospitalist Physician
  • Gulfport, MS
National Provider Identifier
1295922854
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
GARDEN PARK HOSPITALIST PROGRAM LLC
Practice address
15200 Community Rd
4TH Floor
Gulfport, MS 39503-3085
Phone
(228) 575-7243
Fax
(801) 575-7420
NPI assigned
Sep 27, 2007
Last updated
May 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Mr. John M. Laverty
Title
VP
Phone
(615) 507-2312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

15200 Community Rd
4TH Floor
Gulfport, MS 39503-3085

Mailing address

15200 Community Rd
4TH Floor
Gulfport, MS 39503-3085
Phone (228) 575-7243

Other identifiers 1

IdentifierTypeStateIssuer
07378761MedicaidMS

National Provider Directory

National Provider Directory

Locations

15200 Community Rd
Fl 4
Gulfport, MS 39503
Phone (228) 575-7243

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1295922854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 COMMUNITY RD",
            "address_2": "4TH FLOOR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033085",
            "telephone_number": "228-575-7243",
            "fax_number": "801-575-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 COMMUNITY RD",
            "address_2": "4TH FLOOR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033085",
            "telephone_number": "228-575-7243",
            "fax_number": "801-575-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN PARK HOSPITALIST PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "LAVERTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-507-2312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07378761",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.