Physicians Care Plaza, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

09295 Issued in MS

Legal business name

PHYSICIANS CARE PLAZA, LLC

Practice address

9344 Three Rivers Rd
Gulfport, MS 39503-4268

Phone

(228) 865-9898

Fax

(228) 863-5616

NPI assigned

Jul 26, 2007

Last updated

Dec 19, 2011By 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

Mrs. Billie J Housel

Title

Credentialing Specialist

Phone

(228) 865-9898

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1316137300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9344 THREE RIVERS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034268",
            "telephone_number": "228-865-9898",
            "fax_number": "228-863-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9344 THREE RIVERS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034268",
            "telephone_number": "228-865-9898",
            "fax_number": "228-863-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CARE PLAZA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "HOUSEL",
        "authorized_official_first_name": "BILLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "228-865-9898",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "09295",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "R852805",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "302G701491",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06238271",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Independent Living
• Phoenix Independent Living Inc
• Phoenix Independent Living Inc
• Phyllis L Dickerson LCSW
• Physical Therapy Clinic of Gulfport
• Physicians Pain and Spine Specialists
• Christopher Scott Pickreign
• Gregory Kevin Picou, D.C.
• Samantha C Pierce, OTR/L
• Brittany Leann Pipkins, FNP-C

• Family Medicine Physician in Gulfport, MS
• Providers in Gulfport, 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 Dec 19, 2011; 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.