Active NPI
Fortress Clinical Research Inc
- General Practice Physician
- Biloxi, MS
National Provider Identifier
1376419879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- FORTRESS CLINICAL RESEARCH INC
- Practice address
- 14501 Lemoyne Blvd
Biloxi, MS 39532-9326 - Phone
- (601) 316-5538
- NPI assigned
- Oct 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Demario Wilson
- Title
- Ceo/ Medical Director
- Phone
- (601) 316-4613
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary | ||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
14501 Lemoyne Blvd
Biloxi, MS 39532-9326
Mailing address
14501 Lemoyne Blvd
Biloxi, MS 39532-9326
Phone (601) 316-5538
National Provider Directory
National Provider DirectoryLocations
14501 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5559
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Biloxi, MS
- NPI 1700763695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784246400000",
"number": "1376419879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14501 LEMOYNE BLVD",
"city": "BILOXI",
"state": "MS",
"postal_code": "395329326",
"telephone_number": "601-316-5538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14501 LEMOYNE BLVD",
"city": "BILOXI",
"state": "MS",
"postal_code": "395329326",
"telephone_number": "601-316-5538"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORTRESS CLINICAL RESEARCH INC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-13",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "DEMARIO",
"authorized_official_title_or_position": "CEO/ MEDICAL DIRECTOR",
"authorized_official_telephone_number": "601-316-4613",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.