Individual provider Active NPI

Michele Fontenelle McLeod, N.P.

  • Family Nurse Practitioner
  • Biloxi, MS
National Provider Identifier
1346261864
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R645982 Issued in MS
Practice address
967 Cedar Lake Rd Ste B
Biloxi, MS 39532-2128
Phone
(228) 396-8531
Fax
(228) 396-1835
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R645982 MS Primary

Addresses

Primary practice location

967 Cedar Lake Rd Ste B
Biloxi, MS 39532-2128

Mailing address

1211 Bexley Church Rd
Lucedale, MS 39452-4643
Phone (601) 947-7334

Other identifiers 3

IdentifierTypeStateIssuer
05238388MedicaidMS
640617252002OtherMSTRICARE
R645982OtherMSSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060207000442 MS Practitioner - Nurse Practitioner 2264447606 Reassigns benefits to 1 organization
I20230828000603 AL Practitioner - Nurse Practitioner 2264447606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Services of the Gulf Coast LLCGroup PAC ID 8426301607, 32 clinicians

Practice addresses (Care Compare)

210 Greeno Rd N
Fairhope, AL 36532-2914
Phone (251) 277-5300

921 Cedar Lake Rd
Suite E
Biloxi, MS 39532-2126
Phone (228) 396-3945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services of the Gulf Coast LLC CurrentSince Sep 15, 2018 Accepting new patients
Cooper Family Medical Center Inc. CurrentSince Sep 15, 2018 Accepting new patients

Locations

10719 Eastern Shore Blvd
Spanish Fort, AL 36527
Phone (251) 270-0900

921 Cedar Lake Rd
Ste E
Biloxi, MS 39532
Phone (228) 396-3945

1018 Cowan Rd
Gulfport, MS 39507
Phone (228) 265-7945

6652 U S Highway 98
Hattiesburg, MS 39402

1113 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 300-5945

8288 Firetower Rd
Ste F
Pass Christian, MS 39571
Phone (228) 222-8900

Interoperability endpoints

  • Direct secure messaging: michele.mcleod.1@24353.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346261864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 BEXLEY CHURCH RD",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394524643",
            "telephone_number": "601-947-7334",
            "fax_number": "228-396-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 CEDAR LAKE RD STE B",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322128",
            "telephone_number": "228-396-8531",
            "fax_number": "228-396-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "MICHELE",
        "middle_name": "FONTENELLE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R645982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05238388",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "640617252002",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R645982",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.