NPIMap

Organization Active NPI

Gulf Coast Childrens Clinic, PA

Doing business as Gulf Coast Childrens Clinic at Wiggins

  • Pediatrics Physician
  • Wiggnis, MS
National Provider Identifier
1376887620
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GULF COAST CHILDRENS CLINIC, PA
Doing business as
Gulf Coast Childrens Clinic at Wiggins
Practice address
930 Main Street Suite a
Wiggnis, MS 39564-0000
Phone
(228) 875-0780
Fax
(228) 875-1009
NPI assigned
Nov 26, 2012
Last updated
Nov 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
GULF COAST CHILDRENS CLINIC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Meichelle Harvey
Title
Administrator
Phone
(228) 875-0780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

930 Main Street Suite a
Wiggnis, MS 39564-0000

Mailing address

3650 Groveland Rd
Ocean Springs, MS 39564-5754
Phone (228) 875-0780

Other names 1

  • Gulf Coast Childrens Clinic at Wiggins Doing business as

National Provider Directory

National Provider Directory
Part of
Gulf Coast Children's Clinic

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1376887620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 GROVELAND RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645754",
            "telephone_number": "228-875-0780",
            "fax_number": "228-875-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAIN STREET SUITE A",
            "city": "WIGGNIS",
            "state": "MS",
            "postal_code": "395640000",
            "telephone_number": "228-875-0780",
            "fax_number": "228-875-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST CHILDRENS CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GULF COAST CHILDRENS CLINIC, PA",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "MEICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-875-0780"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Childrens Clinic at Wiggins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.