Ochsner Medical Center - Hancock LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

11214 Issued in MS

Legal business name

OCHSNER MEDICAL CENTER - HANCOCK LLC

Practice address

3068 Port and Harbor Dr
Bay St Louis, MS 39520

Phone

(228) 533-9000

Fax

(228) 467-8799

NPI assigned

Jul 2, 2007

Organization subpart

Yes

Parent organization

OCHSNER MEDICAL CENTER - HANCOCK LLCAs reported in NPPES

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

Authorized official

Name

Alan E. Hodges

Title

Ceo

Phone

(228) 467-8744

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ochsner Health Center - Port Bienville Doing business as

Electronic endpoints 1

Part of

Ochsner Medical Center - Hancock LLC

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Ochsner Medical Center - Hancock LLC

  • General Acute Care Hospital
  • Bay Saint Louis, MS
  • NPI 1588629968

  Member Of

  NPD member
• Ochsner Pharmacy and Wellness, LLC

  • Clinic Pharmacy
  • New Orleans, LA
  • NPI 1518073824

  Member Of

  NPD member

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ochsner Medical Center - Hancock LLC

  • General Acute Care Hospital
  • Bay Saint Louis, MS
  • NPI 1588629968
  NPPES parent name

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1336346451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8744",
            "fax_number": "228-467-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3068 PORT AND HARBOR DR",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "39520",
            "telephone_number": "228-533-9000",
            "fax_number": "228-467-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHSNER MEDICAL CENTER - HANCOCK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCHSNER MEDICAL CENTER - HANCOCK LLC",
        "enumeration_date": "2007-07-02",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "228-467-8744"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MS",
            "license": "11214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015655",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Health Center - Port Bienville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ochsner Health Center - Port Bienville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Stanton Newman Jr., OD
• North Beach Medical LLC
• Rachael Crittenden Nuschke, FNP
• Naomi Nicole Dieckmann Oberhofer
• Ochsner Clinic LLC
• Ochsner Mississippi, LLC
• Troy William Pepperman, MS, ATC
• Pharmacy in the Bay,LLC
• Barry Pickreign
• Ansonya Renee Piernas

• All providers in Bay St Louis, MS
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.