NPIMap

Individual provider Active NPI

Cherryl D Purvis, NP

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1386772283
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R655481 Issued in MS
Practice address
15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637
Phone
(228) 832-9038
Fax
(228) 832-9990
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X R655481 MS
Family Nurse Practitioner 363LF0000X R655481 MS Primary

Addresses

Primary practice location

15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637

Mailing address

15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637
Phone (228) 832-9038

Other identifiers 2

IdentifierTypeStateIssuer
00201815MedicaidMS
R655481OtherMSMS - STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000303 MS Practitioner - Nurse Practitioner 7911918149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

15286 Community Rd
Gulfport, MS 39503-3509
Phone (228) 832-5151

Hospital & facility affiliations

  • Mississippi Homecare of Picayune Home health agency, Picayune, MS, CCN 257141
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R655481MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Jan 3, 2022 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 14, 2023 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 14, 2023 Accepting new patients
Primary Care Medical Center of Gulfport, PLLC CurrentSince Mar 15, 2015 Accepting new patients
Singing River Gulfport CurrentSince Jan 3, 2022 Accepting new patients

Locations

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

15444 Dedeaux Rd
#B
Gulfport, MS 39503
Phone (228) 832-9038

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

14055 Seaway Rd
#200
Gulfport, MS 39503
Phone (228) 832-9038

1203 Broad Ave
Gulfport, MS 39501
Phone (228) 547-8814

15286 Community Rd
Gulfport, MS 39503
Phone (228) 822-6022

Interoperability endpoints

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

Organizations & group practices 7

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.

Hospital & facility affiliations 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1386772283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15444 DEDEAUX RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-832-9038",
            "fax_number": "228-832-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15444 DEDEAUX RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-832-9038",
            "fax_number": "228-832-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIS",
        "first_name": "CHERRYL",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "R655481",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R655481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00201815",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS - STATE LICENSE",
            "identifier": "R655481",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.