Medical Foundation of South Ms

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDICAL FOUNDATION OF SOUTH MS

Practice address

1110 Broad Ave
Suite 700
Gulfport, MS 39501-8907

Phone

(228) 864-4151

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Randy Robinson

Title

Administrator

Phone

(228) 865-1453

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Medical Foundation of South MS Lab Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Saleme, M.D.

  • Pediatrics Physician
  • Scott, LA
  • NPI 1811002744
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1356469423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 31ST AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012750",
            "telephone_number": "228-865-1453",
            "fax_number": "228-865-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BROAD AVE",
            "address_2": "SUITE 700",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395018907",
            "telephone_number": "228-864-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF SOUTH MS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-865-1453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119065",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Foundation of South MS Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Med-Trans Corporation
• Medi-Lab Diagnostics Center LLC
• Medi-Lift of Ms, LLC
• Medical Foundation of South Mississippi
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Logic Inc

• Clinical Medical Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.