Rebecca Anne Waldrup, DO

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

32648 Issued in MS

Practice address

Keesler Air Force Base Medical Center
101 Fisher St
Biloxi, MS 39534

Phone

(228) 376-0500

NPI assigned

Jun 24, 2019

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mississippi Emergency Department Services PCGroup PAC ID 7113453960, 40 clinicians

Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Singing River Health System Hospital, Pascagoula, MS, CCN 250040
• Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roneill@direct.mhg.com

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

• Mississippi Emergency Department Services PC

  • Emergency Medicine Physician
  • Pascagoula, MS
  • NPI 1881427961
  Medicare reassignment Care Compare group NPD
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment Care Compare group
• Emergency Room Group LTD

  • Emergency Medicine Physician
  • Pascagoula, MS
  • NPI 1093112039
  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  dba Memorial Emergency Physicians

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Singing River Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1639797913
  Care Compare affiliation
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937

  Hospital

  Care Compare affiliation
• Singing River Health System

  • General Acute Care Hospital
  • Pascagoula, MS
  • NPI 1124136593
  Care Compare affiliation

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1366003105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 HANSHAW RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395649458",
            "telephone_number": "319-784-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KEESLER AIR FORCE BASE MEDICAL CENTER",
            "address_2": "101 FISHER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39534",
            "telephone_number": "228-376-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4881 Sugar Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Wright Patterson AFB",
            "state": "OH",
            "postal_code": "454335529",
            "country_code": "US",
            "telephone_number": "937-656-3172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Bodin Cir",
            "address_purpose": "LOCATION",
            "city": "Travis AFB",
            "state": "CA",
            "postal_code": "945351809",
            "country_code": "US",
            "telephone_number": "707-423-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-395-8949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDRUP",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.015002",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "32648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "34.015002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI MEDICAL LICENSE",
            "identifier": "32648",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Wal-Mart Vision Center 30-1088)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4586)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6849)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1088)
• Max Waldrup, MD
• Walgreen Co (Walgreens #04172)
• Katherine Diane Walker, LMSW
• Kenitra Nicole Walker, CTRS
• Veronica Lynn Walker, AGPCNP
• Caitlin Wall

• Emergency Medical Services (Emergency Medicine) Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.